Cataract Awareness Month

Cataracts are the leading cause of blindness in the United States, according to Prevent Blindness America, which declared June as Cataract Awareness Month. Cataracts affect more than 24 million Americans 40 and older. More than half of all Americans have cataracts by the time they are 80 years old, but cataracts can also appear in young adults or even newborns. Prevent Blindness America (PBA) estimates that by 2020, 30 million Americans will have cataracts. Unlike many other causes of vision loss, vision loss resulting from cataracts can be managed or significantly restored. There is no better time than Cataract Awareness Month to learn the symptoms and risk factors of cataracts, and to schedule an appointment with an eye care specialist.

What Causes Cataracts?

There are several risk factors that may lead to cataracts, including:

• Heredity–family history of cataracts
• Inflammation of the eye
• Certain diseases such as diabetes or metabolic disorders, which can increase your risk of developing cataracts
• Intense heat or long-term exposure to UV rays from the sun
• German measles while pregnant can cause the newborn to be born with cataracts
• Long-term steroid use
• Eye injury, also known as traumatic cataracts
• Hypertension
• Smoking or alcohol use
• High myopia, or nearsightedness
• Medications such as statin medicines used to reduce cholesterol, or hormone replacement therapy

Cataracts may develop in one eye, particularly traumatic cataracts. More often, they develop in both lenses. Like myopia or astigmatism, they don’t always advance in the same way or at the same rate. One eye can have greater vision loss than the other as cataracts develop.

How does Cataracts Affect Vision?

The lens of the eye contains mostly water and protein. The protein in the eye is normally arranged in a way that keeps the lens clear, allowing light to pass through it. Cataracts occur when proteins in the lens of the eye begin to clump up.

The lens of the eye acts as a camera lens. It focuses light on the retina for clear vision. It also adjusts the eye’s focus, helping us to see things both close and far away.

There are several types of cataracts, and they are categorized by where they form and what causes them.

• A subcapsular cataract forms at the back of the lens. This type is more common in people with diabetes or those taking high doses of steroids. This form of cataract will interfere with reading and reduce your vision in bright light and can cause glare or halos around lights at night.
• A nuclear cataract forms in the nucleus (central zone) of the lens. These cataracts most often occur because of aging. This cataract will turn your lenses brown and interfere with your ability to detect color.
• A cortical cataract forms white, wedge-like opacities that start at the edge of the lens and work their way to the center. They look like wagon spokes and form in the lens cortex. This is the part of the lens that surrounds the central nucleus. These types of cataracts affect your peripheral vision and causes problems with glare.

Since cataracts tend to form over a long period of time, you may not know you have a cataract for years. If left undiagnosed, your vision may eventually acquire a brownish shade. Here, the cataract doesn’t affect your vision. As cataracts progresses, you may lose the ability to identify blues and purples. Your vision will start to dull or blur, and you will develop poor night vision, and halos may appear around lights, headlights, or lamplights. Having to change prescriptions in your eyeglasses or contacts regularly can also be a sign of a developing cataract.

How are Cataracts Detected?

A comprehensive eye exam includes testing for cataracts and other disorders of the eye such as macular degeneration and glaucoma.

You can expect:

• A review of your personal and family health history including any history of eye problems.
• A visual acuity test to determine how well you see at various distances.
• A dilated eye exam, where drops are placed in your eyes to dilate your pupils. Your retinas and optic nerves will be examined for signs of damage and other issues.
• Tonometry will measure the pressure inside the eyes. Numbing drops might be applied for this test.

If your doctor detects signs of a cataract, they might do additional testing to see whether your eyes are sensitive to light or if your peripheral vision (side vision) is affected.

If you are Diagnosed with Cataracts

There are several treatment options available for cataracts, depending on the severity. Your eye care professional will probably recommend new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures prove unsuccessful, the only option left is surgery. Some people can go years before needing surgery.

When the Treatment is Surgery

Traditional cataract surgery typically involves using a blade to remove the clouded lens and replacing it with an artificial one. It is usually only recommended when vision loss interferes with your daily activities, but it can also be recommended if it interferes with the eye care professional’s ability to examine or treat the rest of your eye. Laser cataract surgery provides a level of safety and comfort similar to bladeless LASIK where a femtosecond laser is used to make to make the incision.

Cataract surgery can slightly increase your risk of retinal detachment especially if you have other eye conditions which can also increase your risk. Talk with your eye care professional about the pros and cons of any options you are considering.

That said, cataract surgery is one of the most commonly performed surgeries, and is usually an outpatient procedure. More than 3 million Americans undergo cataract surgery every year, according to PBA. Nearly nine out of ten people who have cataract surgery regain very good vision, between 20/20 and 20/40.

It is important to speak with your doctor about vision issues you might be having, and to make informed decisions about the care and protection of your eyes. Your eye care professional should be able to sit down with you and discuss all your risk factors and help you weigh those against the benefits of the treatment options offered. If you are 65 or older, it’s important to get a complete eye exam every one or two years, even if you have no problems seeing. Schedule your appointment during Cataract Awareness Month and be proactive about your eye health.