Cataracts

A cataract occurs when proteins in the lens of the eye break down, causing cloudy, blurry vision. When a cataract forms, it prevents light rays from passing through the lens to the retina – the thin, light-sensitive nerve tissue that lines the back of the eye.

The highly skilled ophthalmologists at University Hospitals Eye Institute’s Center for Anterior Segment Diseases and Surgery offer expert diagnosis and treatment of cataracts, which are cloudy areas that form on the eye’s lens.

Early on, a cataract may not cause problems because it may only affect a small part of the lens. But as a cataract grows over time and blocks more light from reaching the retina, it can cause vision to become dull and blurry. Cataracts can’t spread from one eye to another. However, many people get cataracts in both eyes.

Types of Cataracts

• Age-related cataracts: The most common type, these cataracts develop as part of the normal aging process. There are three main types of age-related cataracts:
  • Nuclear sclerotic cataract: Affects the center of the lens.
  • Cortical cataract: Affects the edges of the lens.
  • Posterior subcapsular cataract: Affects the back of the lens.
• Secondary cataracts: This type is usually caused by a disease, such as diabetes. The use of steroids can also cause secondary cataracts.
• Congenital/pediatric cataracts: Some infants are born with cataracts (congenital cataracts), and some children develop them in childhood (pediatric cataracts), often in both eyes. While some congenital/pediatric cataracts don't affect vision, others do and must be removed.
• Traumatic cataracts: Injury to one or both eyes can cause traumatic cataracts. Traumatic cataracts can occur either immediately after an injury or years later.

Cataract Symptoms

Symptoms of cataracts include:

• Cloudy, blurry, filmy or foggy vision
• Colors that look faded or duller than normal
• Sensitivity to bright lights (sunlight, headlights or lamps)
• Glare, including streaks or halos that appear around lights
• Trouble seeing at night
• Changes in vision prescription, including worsening near-sightedness
• Double vision
• Needing a brighter light to read

Cataracts often develop slowly, so early symptoms may be unnoticeable and gradually get worse over time. Some cataracts may briefly improve close-up vision, but eyesight typically worsens as it grows.

What Causes Cataracts?

Most cataracts occur because of normal changes in the eyes caused by aging. Risk factors that can contribute to the development of cataracts include:

• Excessive alcohol consumption
• Smoking
• Nutritional deficiency
• Diabetes
• Unprotected exposure to UV sunlight
• Some diuretic medicines
• Some tranquilizers
• Obesity
• Family history of cataracts
• Previous eye injury or eye inflammation
• Previous eye surgery
• Prolonged use of corticosteroid medicines

How Are Cataracts Diagnosed?

Your eye care provider will perform an eye exam and review your health history. You may also have certain tests, including:

• Visual acuity test: This is the common eye chart test used to measure vision.
• Pupil dilation: Using special eye drops, the pupil is widened (dilated) to allow close-up examination of the retina.

Your eye care provider may perform other tests to help them learn more about the condition of your eye.

Cataract Treatment

Cataract treatment depends on your symptoms, age, general health and the progression of your condition. Early on, vision loss caused by a cataract may be helped by changing your eyeglasses prescription. If that doesn’t help, cataract surgery is the only way to remove cataracts and restore clear vision.

Cataract surgery replaces the clouded lens with a new artificial one. It’s one of the safest, most effective and most common surgeries in the U.S. If you have cataracts in both eyes, your provider will schedule separate surgeries for each eye.

During cataract surgery, the lens is removed in one of two ways:

• Small incision cataract surgery (phacoemulsification): After the surgeon makes a small incision on the edge of the cornea, they use ultrasound waves to break up the lens into many tiny pieces, which are then removed by suction through the same incision. This is the most common type of cataract surgery.
• Extracapsular surgery: The surgeon makes a larger incision on the edge of the cornea and extracts the hard center of the lens in one piece. The rest of the lens is removed by suction.

Once the lens is removed, a new artificial lens – called an intraocular lens (IOL) – is placed into the eye. With an IOL, a person usually has better eyesight, because light can pass through to the retina unblocked. You will not feel or see the new lens.