Overview
Most cataracts develop slowly and don't disturb your eyesight early on. But with time, cataracts will eventually interfere with your vision.
At first, stronger lighting and eyeglasses can help you deal with cataracts. But if impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.
Symptoms of Cataracts
Common symptoms of cataracts include:
- blurry vision
- trouble seeing at night
- seeing colors as faded
- increased sensitivity to glare
- halos surrounding lights
- double vision in the affected eye
- a need for frequent changes in prescription glasses
Cataract Causes and Types
Cataracts form when protein builds up in the lens of your eye and makes it cloudy. This keeps light from passing through clearly. It can cause you to lose some of your eyesight. There are many types of cataracts.
Nuclear cataracts
Also called a nuclear sclerotic cataract, this is the kind doctors see most. Anyone who lives long enough usually ends up with one.
They form in the center of the lens, known as the nucleus. As they get worse, your reading vision may actually get better. It's called second sight, but it doesn't last long.
Over time, the lens hardens and turns yellow or even brown. You have a hard time seeing small details, colors get less rich, and you see halos around bright objects at night.
Cortical cataracts
These take shape on the outside edge of your lens, called the cortex. They start as white wedges, like triangles that point toward the center of your eye. As they grow, they scatter light.
The main symptom is glare. You may find it hard to drive at night. They can also make your vision hazy, like you're looking through a fog. It may be hard to tell similar colors apart or to judge how far away an object is.
Since they can spell trouble for both near and distance vision, you typically get them removed early on.
Posterior subcapsular cataracts
These form just inside the back of your lens capsule, the part of your eye that surrounds the lens and holds it in place. They're directly in the path of light as it passes through the lens.
They're quicker to come on than other cataracts, and you may get symptoms within months. They affect your close-up vision and make it harder to see in bright light.
Anterior subcapsular cataracts
This type forms just inside the front of your lens capsule. An injury or swelling in your eye can lead to one. So can a type of eczema called atopic dermatitis.
Congenital cataracts
These are cataracts that you're born with or that form when you're a child. Some are linked to your genes, and others are due to an illness, like rubella, that your mother had during pregnancy.
When they're small or outside the center of the lens, they may not need treatment. But when a baby's born with one that blocks vision, a doctor needs to remove it because it can stop the eye from learning to see.
Traumatic cataracts
Many kinds of injuries can lead to a cataract. You can get one if you're hit in the eye by a ball or get hurt from a burn, chemical, or splinter. The cataract could come on soon after the injury or not show up until years later.
Secondary cataracts
When another condition or a medical treatment leads to a cataract, doctors call it secondary. Diabetes, taking steroids like prednisone, and even cataract surgery are possible causes.
Radiation cataracts
You may know that it's important to protect your skin from the sun's ultraviolet (UV) radiation, but it can take a toll on your eyes, too. You can sometimes get cataracts if you spend too much time in the sun without eye protection.
People who work outdoors, like fishers and farmers, are more likely to get this kind of cataract. To prevent it, wear sunglasses with 100% UVA and UVB protection.
Cataracts are also a possible side effect from radiation therapy for cancer.
Lamellar or zonular cataracts
This type typically shows up in younger children and in both eyes. The genes that cause them are passed from parent to child.
These cataracts form fine white dots in the middle of the lens and may take on a Y shape. Over time, the whole center of the lens may turn white.
Posterior polar cataracts
You get these on the back center of your lens, and they're often due to genes that are passed down through your family.
Posterior polar cataracts often don't cause symptoms, which is good because they're hard to remove.
Anterior polar cataracts
They form on the front and center of your lens and look like small white dots. These cataracts typically don't bother your vision.
Post-vitrectomy cataracts
Vitrectomy is surgery to remove your vitreous, the clear gel at the center of your eye. The operation can help with certain eye problems but may lead to a cataract.
Christmas tree cataracts
Also called polychromatic cataracts, they form shiny, colored crystals in your lens. They're most common in people who have a condition called myotonic dystrophy.
Brun scent cataracts
If you don't treat a nuclear cataract, it turns very hard and brown. This is called brunescent.
It makes it hard for you to tell colors apart, especially blues and purples. Surgery to remove it is harder, longer, and riskier than when you get treatment earlier on.
Diabetic snowflake cataracts
This is a rare type of cataract that can happen if you have diabetes. It gets worse quickly and forms a gray-white pattern that looks like a snowflake.
Treatment
Home treatment. Early on, you may be able to make small changes to manage your cataracts. You can do things like:
- Use brighter lights at home or work
- Wear anti-glare sunglasses
- Use magnifying lenses for reading and other activities
New glasses or contacts. A new prescription for eyeglasses or contact lenses can help you see better with cataracts early on.
Surgery. Your doctor might suggest surgery if your cataracts start getting in the way of everyday activities like reading, driving, or watching TV. During cataract surgery, the doctor removes the clouded lens and replaces it with a new, artificial lens (also called an intraocular lens, or IOL). This surgery is very safe, and 9 out of 10 people who get it can see better afterwards.
Talk about your options with your doctor. Most people don’t need to rush into surgery. Waiting to have surgery usually won’t harm your eyes or make surgery more difficult later. Remember these tips:
- Tell your doctor if cataracts are getting in the way of your everyday activities
- See your doctor for regular check-ups
- Ask your doctor about the benefits and risks of cataract surgery
- Encourage family members to get checked for cataracts, since they can run in families
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