Cataracts

Vision problems are common, but that does not mean you have to live with them or be happy about them. In fact, if you have cloudy vision, or are experiencing issues with your eyesight you will want to see an eye care practitioner quickly so it can be diagnosed and your vision can be restored as quickly and painlessly as possible. One vision problem that is common in elderly and diabetics is cataracts.

What is a cataract?

A cataract is a clouding of the eye's natural lens. The lens lies behind the iris and the pupil. It is made mostly of water and protein. The protein is arranged in a way that keeps the lens clear and allows light to pass through it. The eye lens works much like a camera lens, it focuses light onto the retina, and adjusts the eye's focus to let you see things clearly up close and far away. However, if the proteins are not arranged properly, vision can be compromised. As we get older, sometimes the proteins in the eye clump together and start to cloud a small area of the lens. This clouding is referred to as a cataract. If it goes untreated it can get worse, making it increasingly difficult to see.

The proteins are called crystalline, and researchers are trying to figure out what causes them to cluster together in this abnormal way that causes the lens to cloud. As of right now, research has found many things that may increase risk, but it is still uncertain as to why.

How do you know if you have a cataract?

Your age can help you determine if your vision problem is caused by cataracts, as it is not common in young people, but really hazy or blurred vision may indicate a cataract.

Cataract symptoms and signs should be watched for so that vision problems can be corrected before they get worse. Because a cataract starts out small, at first it has little effect on your vision. However, some notice their vision is a little blurred, sort of like looking through dirty sunglasses.

Another symptom to watch for is that of light from a lamp or the sun seem too bright, even glaring at times, or if you drive at night, the light from headlines seeming too bright, or glaring, or more than they may have seemed to you previously.

Another sign of a cataract is that of colors not seeming as vibrant or bright.

One thing that is important to note is what symptoms you have as there are three types of cataracts, and you have different symptoms depending on which type of cataract you have. For example, when a nuclear cataract first develops it can bring about a temporary improvement in your near vision, called "second sight." As the cataract gets worse, the improvement goes away, and you will get worse vision. With a subcapsular cataract, you won't likely see any symptoms until the cataract is developed.

There are three types of cataracts:

Cataracts are classified as one of three types, and your eye doctor will let you know which if you do have one:

1.     Cortical cataract: A cortical cataract is a cataract that first forms in the lens cortex. It extends from the outside of the lens to the center. This is a common form of cataract for people who suffer from diabetes.
2.     Subcapsular cataract: A subcapsular cataract begins at the back of the lens. This is a cataract that may also develop in people with diabetes, but is also found in people with high farsightedness, retinitis pigmentosa or those taking high doses of steroids.
3.     Nuclear cataract: This is a typical cataract form, and usually diagnosed the fastest. A nuclear cataract is most commonly seen as it forms because it forms at the nucleus, or center, of the lens, and spreads. It is usually due to natural aging, not to problems associated with diabetes, etc. as other cataract types are.

What causes cataracts?

While it is clear that cataracts form as a result of the proteins clumping, no one knows for sure why the eye's lens changes as we age, and why this happens. While it is clear what leads to the forming cataracts, it is unclear what factors lead to the proteins clumping, and thus it is still unknown how to prevent this vision problem.

There is some research out there to help narrow down the causes of cataracts, so we will look at those:

First, there are several studies that suggest that exposure to ultraviolet light adds to and is associated with cataract development. If you want to help prevent this vision problem it would be wise to wear sunglasses when you are out of doors, or wear a hat to lessen your exposure to the sun.

Second, other studies suggest that other types of radiation can add to your risk of developing cataracts. Thus, people who are exposed to higher amounts of cosmic radiation may form nuclear cataracts. For example, airline pilots and astronauts may have higher risk for developing nuclear cataracts.

Third, because of the high frequency, studies suggest people with diabetes are at higher risk for developing a cataract. It is still unclear what part of being diabetic is leading to this higher risk of cataracts, just that they are associated. More research is needed to find out why that is exactly.

Fourth, studies show that users of steroids, diuretics, and major tranquilizers may lead to higher risk of cataracts, but again, the reason why is unclear.

Fifth, there are some studies that show diet affects your risk of developing cataracts. For example, a diet high in salt increases your risk, while a diet that is high in antioxidants, such as beta-carotene (vitamin A), selenium and vitamins C and E, may forestall cataract development.

Sixth, lead exposure, cigarette smoke, air pollution and heavy alcohol consumption have all been linked to increased risk of cataract development, but it is still unclear as to why.

What are your cataract treatment options?

Because there is little evidence or hard proof of what leads to increased risk of cataracts, it is hard to know what you can do to prevent cataracts, however, there are treatment options available.

The most popular treatment option the insertion of an intraocular lens (IOL). This is a lens that is implanted in the eye in place of the patient's clouded natural lens. This lens is yellow in order to filter out blue light which is thought to be harmful to eyes.

If your symptoms are mild, or the cataract is small, you can improve your vision using glasses, bifocals, magnification, etc. but after time, these treatment options will no longer be effective and a more intensive treatment must be considered.

Cataract surgery is the most common option if the cataract had developed to a point that it is significantly impairing vision. The biggest problem is that many people think it is simply part of aging to have vision problems, and do not realize they may have cataracts that can be removed easily using surgery, and restore vision painlessly. Cataract surgery is very successful in restoring vision, and since it is the most frequently performed surgery in the US is low risk. Each year more than 3 million Americans have cataract surgery. And, it has very high success rates for restoring vision with ninety percent of those who have surgery getting 20/20 and 20/40 vision.

So how does IOL cataract surgery work?

To put it simply, during surgery, the surgeon will remove your clouded lens and then replace it with a clear, plastic intraocular lens (IOL). Through the years IOLs have gotten better and better, the surgery is now very simple. The fact is, for many it actually results in improved vision as the lenses are better than ever. By putting in an IOL, surgeons can help you see better at all distances, near and far. Some of the IOL lenses today act as sunglasses as well, blocking ultraviolet and blue light rays, which research indicates may damage the retina. As you can see, the technology has improved significantly, and having cataract surgery can be a great option for improving and restoring vision as well as for protecting your eye from future problems.

If you think you may have a vision problem caused by a cataract, do something about it. Go in for an eye exam, and be sure to let your eye care practitioner know of any symptoms you may be experiencing. This will help them to better diagnose you, and will help you to come up with the best treatment option for your condition, whether it is the low risk cataract surgery, or something simpler such as corrective lenses or bifocals.