Cataract: What causes it? And how to treat it?

Our eye is one of the most vital organs in our body. It helps us to do almost everything in our life. It is important that we take proper care of it in order to avoid developing short-term or long-term eye problems such as reduced vision or cataract. Although very common, not a lot is known about cataracts. In this article we are making an attempt to bridge this gap and help the world become more aware of this disease and what causes it and what can they do to prevent developing one.

Q. What is a cataract?

A. A cataract is a common eye condition characterized by the clouding of the lens, resulting in blurred vision and visual impairment. It occurs when the normally clear lens of the eye becomes opaque or cloudy, obstructing the passage of light to the retina. This clouding is usually a gradual process and can affect one or both eyes. If left untreated, cataracts can significantly impact a person’s ability to perform daily activities and can ultimately lead to blindness.

The lens of the eye plays a vital role in focusing light onto the retina, which then sends visual signals to the brain. The lens is primarily made up of water and proteins arranged in a precise manner to maintain its transparency and clarity. However, with aging and other factors, these proteins can clump together, forming a cataract.

Q. What are the symptoms of a cataract?

A. Recognizing the symptoms of cataracts is crucial for early detection and appropriate management. Symptoms may vary depending on the stage and severity of the cataract. Here are some common symptoms associated with cataract.

• Blurred Vision:

Blurred vision is one of the most common symptoms of cataracts. As the cataract develops, the lens becomes clouded, leading to a gradual loss of clarity in vision. The blurriness may initially be mild, affecting specific objects or distant vision. Over time, the blurriness may progress, making it challenging to see clearly at various distances.

• Increased Sensitivity to Glare:

Individuals with cataracts often experience heightened sensitivity to glare. Glare occurs when excessive light enters the eye, causing discomfort and difficulty seeing clearly. Glare can be particularly bothersome in bright sunlight or when looking at bright lights, such as oncoming headlights while driving at night. Cataracts can amplify the effect of glare, making it challenging to see objects or navigate in certain lighting conditions.

• Difficulty Seeing in Dim Light:

Another symptom of cataracts is reduced vision in dimly lit environments. Individuals with cataracts may find it increasingly challenging to see clearly in low-light situations, such as reading in dimly lit rooms or recognizing objects in low-light conditions.

• Decreased Contrast Sensitivity:

Cataracts can also affect contrast sensitivity, making it harder to distinguish between objects with similar tones or colors. With cataracts, individuals may have difficulty differentiating between shades of grey or distinguishing objects against a similar background.

• Colour Distortion:

In some cases, cataracts can cause a change in color perception or color vision. Colors may appear faded, less vibrant, or yellowish. This can affect the ability to appreciate and differentiate between different colors, impacting activities such as choosing clothes or identifying traffic signals accurately.

• Double Vision:

Double vision, also known as diplopia, can occur in individuals with cataracts. This symptom manifests as seeing two images instead of one, which can make it challenging to focus and perceive objects accurately. Double vision can occur in one eye or both eyes and may be temporary or persistent.

Q. Who is more prone to developing a cataract?

A. Cataract is a common eye condition that can affect individuals of all ages. However, certain factors increase the risk of developing cataracts. Understanding who is more prone to develop cataracts can help identify individuals, who may require closer monitoring and preventive measures.

• Age:

Age is a significant risk factor for developing cataracts. The majority of cataract cases occur in older individuals. As individuals grow older, the proteins within the lens may clump together and form cloudy areas, gradually impairing vision. This process is a natural part of aging and is known as age-related cataracts.

• Genetic Factors:

Genetic factors can influence the development of cataracts. Some individuals may inherit certain gene variations that make them more susceptible to cataract formation. Studies have identified specific genes associated with cataracts, including those involved in the regulation of lens proteins. However, the interplay between genetics and environmental factors in cataract development is complex and still being investigated.

• Environmental Factors:

Several environmental factors contribute to the development of cataracts. Prolonged exposure to ultraviolet (UV) radiation from sunlight is a significant risk factor. UV radiation can cause oxidative damage to the lens, leading to cataract formation. Protecting the eyes from UV radiation by wearing sunglasses with UV protection and wide-brimmed hats can help reduce the risk.

Other environmental factors, such as long-term exposure to certain chemicals or toxins like tobacco smoke, air pollution, and ionizing radiation, can also increase the likelihood of developing cataracts. Minimizing exposure to these environmental risk factors is important in reducing the risk of cataract development.

• Medical Conditions

Certain medical conditions and eye traumas can contribute to cataract formation. Diabetes is one such condition that increases the risk of cataracts. The high blood sugar levels associated with diabetes can cause changes in the lens structure, leading to cataract development.

• Eye Trauma:

Eye traumas, such as injuries or previous eye surgeries, can accelerate cataract formation. Trauma to the eye can disrupt the normal structure of the lens and promote the development of cataracts.

• Lifestyle Factors:

Lifestyle factors can also impact cataract development. Smoking has been consistently linked to an increased risk of cataracts. Studies have shown that smokers have a higher likelihood of developing cataracts compared to non-smokers. Quitting smoking or avoiding smoking altogether can help reduce the risk.

Q. How do you treat a cataract?

A. Treatment options for cataracts depend on various factors, including the severity of the cataract, the impact on vision, and the individual’s overall health. Here are the primary treatment approaches for cataracts.

Non-Surgical Management:

In the early stages of cataract development, non-surgical management strategies may be employed to improve vision and manage symptoms. These strategies include:

1. Prescription Glasses: In the early stages of a cataract, prescription glasses may help improve vision by compensating for the refractive errors caused by the cataract. Glasses can provide clearer vision and enhance visual acuity, especially for individuals with mild cataracts.

2. Changes in Eyeglass Prescription: As the cataract progresses, frequent changes in eyeglass prescription may be necessary to maintain optimal vision. Regular eye examinations with an optometrist or ophthalmologist can help determine the appropriate prescription adjustments.

3. Improved Lighting: Adequate lighting can significantly improve vision for individuals with cataracts. Increasing the brightness of lighting fixtures, using task lighting for specific activities, and minimizing glare can enhance visual clarity and reduce visual discomfort.

While these non-surgical measures can only manage symptoms temporarily, the definitive treatment for cataracts is surgical intervention.

Cataract Surgery:

Cataract surgery is the most effective and commonly performed treatment for cataracts. It involves removing the cloudy natural lens and replacing it with an artificial intraocular lens (IOL). Cataract surgery is typically an outpatient procedure and is associated with high success rates and minimal complications.

1. Phacoemulsification: Phacoemulsification is the most common technique used in cataract surgery. The procedure is done under topical anesthesia i.e. without any need for injection and involves creating a small incision of 2.2mm in the cornea, through which an ultrasonic probe is inserted. The probe emits ultrasound waves that break up the cloudy lens into small fragments, which are then gently suctioned out. Once the lens is removed, an IOL is implanted to replace the natural lens and restore vision.

2. Small Incision Cataract Surgery (SICS): SICS is an alternative surgical technique used for more advanced or complicated cataracts. In this, a larger incision is made to remove the entire lens in one piece, leaving the back portion of the lens capsule intact. A lens is then inserted into the remaining capsule for vision correction. This procedure is done under local anesthesia i.e. Peribulbar block and no stitches are needed to seal the incision as the self-sealing tunnel technique is used.

3. Extracapsular Cataract Extraction (ECCE): This is again an alternative technique used for very complicated cataracts, requiring larger incisions and stitches are required to seal the incision.

Types of Intraocular Lenses (IOLs):

After cataract removal, an artificial intraocular lens (IOL) is implanted to restore vision. There are different types of IOLs available, each with its unique characteristics and benefits. The options include:

1. Monofocal IOLs: Monofocal IOLs provide clear vision at a single focal point, typically for distance vision. Individuals who choose mono-focal IOLs may still require glasses for activities such as reading or near-vision tasks.

2. Multifocal IOLs: Multifocal IOLs offer multiple focal points, allowing for vision correction at various distances. These lenses reduce the dependence on glasses for both near and distant vision. However, some individuals may experience visual disturbances, such as glare or halos, particularly in low-light conditions.

3. Toric IOLs: Toric IOLs are designed to correct astigmatism in addition to cataract removal. These lenses have different powers in different meridians, allowing for improved vision in individuals with astigmatism. Glasses may still be required for reading or close-up tasks.

4. Accommodating IOLs: Accommodating IOLs are designed to mimic the natural lens and adjust their position within the eye to provide a range of vision. These lenses can provide good distance and intermediate vision, reducing the need for glasses. However, some individuals may still require glasses for close-up tasks.

The choice of IOL depends on several factors, including the individual’s visual needs, lifestyle, and eye health. It is essential to discuss the available options with the ophthalmologist to determine the most suitable IOL for each individual case.

Post-Surgery Recovery and Follow-Up:

After cataract surgery, individuals typically experience a short recovery period. Most people notice significant improvements in vision within a few days. However, complete healing may take several weeks. During the recovery period, it is crucial to follow the post-operative instructions provided by the surgeon, which may include the use of prescribed eye drops and avoiding activities that could strain the eyes.

Regular follow-up appointments with the ophthalmologist are necessary to monitor the healing process and ensure optimal outcomes. The doctor will assess visual acuity, prescribe any necessary corrective lenses, and address any concerns or complications that may arise.

Q. How can you prevent yourself from developing a cataract?

A. While cataract is primarily age-related and influenced by genetic factors, certain preventive measures can help reduce the risk or delay the development of cataract, such as:

Protective Eyewear and UV Radiation:

Ultraviolet (UV) radiation from the sun is a risk factor for cataract development. Protecting your eyes from UV radiation is crucial in preventing or reducing the risk of cataracts. Here are some preventive measures:

1. Wear Sunglasses: Choose sunglasses that block 100% of UVA and UVB rays. Look for sunglasses labeled with 100% UV protection. Additionally, consider sunglasses with wraparound or large frames to shield the eyes from direct sunlight and peripheral UV exposure.

2. Wide-Brimmed Hats: Along with sunglasses, wear wide-brimmed hats to provide additional shade and protection for your eyes from the sun’s harmful rays.

Healthy Diet and Nutrition:

A nutritious diet rich in antioxidants and certain nutrients can support eye health and potentially lower the risk of cataracts. Consider the following dietary recommendations:

1. Fruits and Vegetables: Consume a variety of fruits and vegetables, especially those rich in vitamin C and antioxidants. Citrus fruits, berries, leafy greens, and colorful vegetables are excellent choices.

2. Omega-3 Fatty Acids: Include foods high in omega-3 fatty acids, such as fatty fish (salmon, mackerel, tuna), flaxseeds, chia seeds, and walnuts. Omega-3 fatty acids have been associated with a reduced risk of cataract development.

3. Limit Processed Foods and Sugar: Minimize the consumption of processed foods and added sugars, as they can contribute to chronic health conditions and potentially affect eye health.

Smoking and Alcohol Consumption:

Smoking and excessive alcohol consumption are associated with an increased risk of cataracts. To reduce the risk:

1. Quit Smoking: If you smoke, quitting is crucial for overall health, including eye health. Smoking cessation can help prevent or slow down cataract development.

2. Limit Alcohol Intake: Moderate alcohol consumption is generally considered safe, but excessive alcohol intake can contribute to cataract development. Drink alcohol in moderation or consider abstaining from it altogether.

Regular Eye Examinations:

Regular eye examinations play a vital role in preventive eye care. A comprehensive eye examination can help detect early signs of cataracts or other eye conditions. Regular check-ups allow for timely intervention and appropriate management strategies.

1. Schedule Routine Eye Exams: Visit an eye care professional regularly for a comprehensive eye examination, especially if you are at a higher risk of cataract due to age or other factors.

2. Discuss Risk Factors: During your eye examination, discuss your risk factors for cataract with your eye care professional. They can provide personalized advice and recommendations based on your specific situation.

Getting the appropriate medical treatment and care is crucial to avoid any associated medical complications.

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