Cataracts: What Are the Best Treatment Options?

Cataracts are a clouding of the normally clear lens of the eye, and they’re commonly related to aging. The risk of developing cataracts increases as you get older, starting around age 40. In fact, more than half of all Americans age 80 or older either have cataracts or have had surgery to get rid of cataracts. 

While the cloudy vision caused by cataracts can affect your daily life—it may be more difficult to read, drive a car at night, or see the expression on a friend’s face—surgical treatment is available. To learn more about cataracts, diagnosing, and treatment, read our latest blog below. 

What are cataracts? 

Inside each of our eyes, we have a natural lens that bends light in order to help us see. In healthy eyes, this lens is clear. However, if you develop something called cataracts, this lens will become cloudy. This cloudy lens can feel like you’re looking through a foggy or dusty car windshield, and your vision can become blurry, hazy, or less colorful.

What are the different types of cataracts? 

There are a few different types of cataracts. These include: 

• Cortical Cataracts. You will begin to notice a cortical cataract appearing if you notice one or more whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As the cataract slowly progresses, the streaks extend to the center of the eye and interfere with light passing through the center of the lens.
• Posterior Subcapsular Cataracts. A posterior subcapsular cataract starts as a small, opaque area that usually forms near the back of the lens, right in the path of light. This type of cataract often interferes with your reading vision, reduces your vision in bright light, and causes glare or halos around lights at night, and they typically progress faster than other types of cataracts.
• Nuclear Sclerotic Cataracts. You may be experiencing a nuclear sclerotic cataract if at first you experience increased nearsightedness or even a temporary improvement in your reading vision. But with nuclear sclerotic cataracts, with time the lens gradually turns more densely yellow and further clouds your vision. As the cataract progresses, the lens can even turn brown. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of color.

What are the signs and symptoms of cataracts? 

Most cataracts develop slowly over time, and don’t tend to disturb one’s eyesight early on. However, as the cataract grows larger, it will cloud more of your vision and can lead to more noticeable symptoms. 

Signs and symptoms of cataracts include:

• Clouded, blurred or dim vision
• Increasing difficulty with vision at night
• Sensitivity to light and glare
• Need for brighter light for reading and other activities
• Seeing “halos” around lights
• Frequent changes in eyeglass or contact lens prescription
• Fading or yellowing of colors
• Double vision in a single eye

How are cataracts diagnosed? 

To determine if you have a cataract, your doctor will take your medical history and perform a comprehensive eye exam. To confirm your diagnosis, your doctor may also perform an eye chart test to check your vision at different distances and tonometry to measure your eye pressure. Your doctor may also check your sensitivity to glare and your perception of colors. 

How are cataracts treated? 

Early in the development of cataracts, stronger lighting and eyeglasses can help treat your impaired vision. But as the condition develops and your vision continues to deteriorate, you may need cataract surgery.

You’ll want to discuss with your optometrist or ophthalmologist about whether or not cataract surgery is right for you. Most eye doctors suggest considering surgery when your cataracts begin to affect your quality of life, or interfere with your ability to perform normal daily activities. But typically there is no rush to perform the surgery because cataracts do not usually harm the eye. However, if you have diabetes, your cataracts may progress at a faster rate than other patients.

If you choose not to forego cataract surgery now, your eye doctor will most likely recommend periodic follow-up exams to see if and how your cataracts are progressing. Discuss with your provider how frequently you should be scheduling these follow-up examinations.

What happens during cataract surgery?

During cataract surgery, the clouded lens is removed and replaced with a clear artificial lens. The artificial lens, also known as the intraocular lens, is positioned in the same place as your natural lens and will remain a permanent part of your eye. 

However, some people have other eye problems that can prohibit the use of an artificial lens. In these situations, your doctor will still remove your cataract but will forego the artificial lens. Instead, your vision may be corrected with eyeglasses or contact lenses. During the procedure, your eye doctor will use local anesthetic to numb the area around your eye, but you usually stay awake while your cataract is removed. Patients undergoing cataract surgery typically don’t need to stay in a hospital after the procedure.

What can I expect after the procedure?

You can expect your vision to begin improving within a few days of cataract surgery. It’s normal for your vision to be blurry at first as your eye heals and adjusts. Your eye may also feel itchy and mildly uncomfortable for a couple days, but avoid rubbing or pushing on your eye if possible and remember to use the prescribed eye drops to help with the healing process. Additionally, colors may seem brighter because you are looking through a new, clear lens.

Normally your eye doctor will want to see you a day or two after your surgery, the following week, and then again after about a month later in order to monitor your eye and how it is healing.

Most of the discomfort should disappear after a couple of days and complete healing often occurs within eight weeks.

Cataracts can interfere with your daily life, and—if left untreated—can even lead to blindness. While it’s possible for a cataract to stop growing, they won’t go away on their own. Thankfully, surgery to remove cataracts is very common and is effective about 90% of the time. If you’re experiencing the signs and symptoms of cataracts, talk to your healthcare provider about your options today. 

Sources

• Cataract Data and Statistics. (n.d.). National Eye Institute.
• T. (2019, March 11). The Facts on Cataracts. The Eye Center. 
• How the Eyes Work. (n.d.). National Eye Institute.
• Cataracts. (n.d.). Johns Hopkins Medicine.
• Kiziltoprak, H., Tekin, K., Inanc, M., & Goker, Y. S. (2019). Cataract in diabetes mellitus. World journal of diabetes, 10(3), 140–153. https://doi.org/10.4239/wjd.v10.i3.140. 
• IOL Implants: Lens Replacement After Cataracts. (2021, April 19). American Academy of Ophthalmology. 
• Cataracts. (n.d.-b). National Eye Institute.