Every seven minutes someone in America becomes legally blind or visually impaired.

Cataracts

A cataract is a cloudy or opaque area (an area you cannot see through) in the lens of the eye.

 

Causes, incidence, and risk factors

The lens of the eye is normally clear. If the lens becomes cloudy, the condition is known as a cataract. Rarely, cataracts may be present at or shortly after birth. These are called congenital cataracts. Adult cataracts usually develop with advancing age and may run in families. Cataracts develop more quickly in the presence of some environmental factors, such as smoking or exposure to other toxic substances. They may develop at any time after an eye injury. Metabolic diseases such as diabetes also greatly increase the risk for cataracts. Certain medications, such as cortisone, can also accelerate cataract formation. Congenital cataracts may be inherited. The gene for such cataracts is dominant (autosomal dominant inheritance), which means that the defective gene will cause the condition even if only one parent passes it along. I families where one parent carries the gene, there is a 50% chance in every pregnancy that the child will be affected. Congenital cataracts can also be caused by infections affecting the mother during pregnancy, such as rubella. They are also associated with metabolic disorders such as galactosemia. Risk factors include inherited metabolic diseases, a family history of cataracts, and maternal viral infection during pregnancy. Adult cataracts are generally associated with aging. They develop slowly and painlessly, and vision in the affected eye or eyes slowly gets worse.

 

Visual problems may include the following changes:

 

Vision problems associated with cataracts generally move towards decreased vision, even in daylight.

Adult cataracts are classified as immature, mature, and hypermature. A lens that has some remaining clear areas is referred to as an immature cataract. A mature cataract is completely opaque. A hypermature cataract has a liquefied surface that leaks through the capsule, and may cause swelling and irritation of other structures in the eye.

Most people develop some clouding of the lens after the age of 60. About 50% of people aged 65-74, and about 70% of those 75 and older, have cataracts that affect their vision.

Most people with cataracts have similar changes in both eyes, although one eye may be worse than the other. Many people with this condition have only slight visual changes, and are not aware of their cataracts.

Factors that may contribute to cataract development are low serum calcium levels, diabetes, long-term use of corticosteroids, and various inflammatory and metabolic disorders. Environmental causes include trauma, radiation exposure, and too much exposure to ultraviolet light (sunlight).

In many cases, the cause of cataract is unknown.

Symptoms

Signs and tests

Other tests that may be done (rarely) include:

Treatment

The only treatment for cataract is surgery to remove it. This is done when a person cannot perform normal activities, even with glasses. For some people, changing glasses, getting stronger bifocals, or using a magnifying lens is helpful enough. Others choose to have cataract surgery.

If a cataract is not bothersome, then surgery is usually not necessary. Sometimes there is an additional eye problem that cannot be treated without first having cataract surgery.

Cataract surgery consists of removing the lens of the eye and replacing it with an artificial lens. A cataract surgeon will discuss the options with the patient, and together they will decide which type of removal and lens replacement is best.