Cataracts: Symptoms, Diagnosis, and Management

Weak eyesight is one of the major changes that come with aging, and cataract is a common cause that affects vision. Worldwide, cataract is the leading cause of blindness. According to the National Blindness and Visual Impairment Survey India 2015–19 report, cataract was the main reason for 66.2% of blindness. 

As cataracts are more common among the older population, they were found to be a major cause of visual impairment in people aged 50 years and above. However, they also occur as a congenital condition or develop in childhood due to genetic diseases, poor nutrition, exposure to harmful radiation, and other factors.

What is a cataract?

A cataract is an opaque or cloudy patch that forms in the lens of the eye. The lens in your eye is transparent and is located behind the iris, which is the colored part of the eye. When light passes through your eyes, the lens changes its diameter to focus, which helps in producing sharp and clear images on the retina.

With age, the flexibility and transparency of the lens decreases, while its thickness increases. The proteins in the lens may end up breaking down and clumping together due to certain age-related conditions or diseases. This leads to the formation of clouded or opaque areas in the lens, causing it to lose its transparency. As the clouded areas become larger and denser, their opacity disrupts the passage of light through the lens. The retina does not get sharp images anymore, causing your vision to become blurry. In advanced stages, complete blockage of light passing through the lens causes blindness in the affected eye.

What are the risk factors of cataracts?

Several factors can increase the chances of developing a cataract. These include:

• Advancing age; generally, after the age of 40, normal eye changes cause the breakdown of lens protein
• Family history of cataracts
• Medical conditions, such as diabetes, hypothyroidism, and Down’s syndrome
• History of eye injury, eye inflammation, or surgery on the eye
• Smoking and alcohol abuse
• Frequent direct exposure to sunlight or radiation 
• Prolonged use of medications like corticosteroids

What are the symptoms of cataracts?

Cataracts can affect one or both eyes. However, the development may not be even, with the impairment in one eye being more advanced than the other. At first, when the cloudy area begins to form, you may not notice that you are developing cataracts. However, in later stages, you may experience blurry or hazy vision and may have trouble reading and performing your regular activities. The symptoms of cataracts include:

• Cloudy or blurry vision
• Double vision in a single eye
• Increased trouble with night vision
• Trouble with reading
• Difficulty in seeing colors or witnessing fading or yellowing of colors
• Changes in the number of your eyesight; frequent replacement of glasses or contact lens
• Being sensitive to light or any glares
• Seeing halos around lights

How are cataracts diagnosed?

If you notice any problems or changes in your vision, consult an ophthalmologist immediately. Routine eye tests will include refraction and visual acuity tests, ie using an eye chart to assess your reading ability along with slit-lamp and retinal examination. The slit-lamp examination helps in examining the lens, iris, and corneas under magnification.  

What can you do if you are diagnosed with cataracts?

If the symptoms of cataracts are manageable, the doctor may recommend you to follow vision correction techniques, such as wearing prescription eyeglasses. The doctor may advise surgical removal of cataracts when they affect your daily life. So, consult your ophthalmologist to make an informed decision.

Here are a few lifestyle changes that you can make to manage the condition until you decide to go for surgery: 

• Do regular eye check-ups as suggested by your ophthalmologist
• Use the right eyeglasses or contact lenses
• Read in a well-lit environment; use a magnifying glass if you have trouble reading
• Make sure that you use sunglasses with adequate UV protection when stepping out in the sun; you may also consider wearing a  broad-brimmed hat to reduce glares
• Avoid driving at night, especially if you experience problems like halos and glares
• Quit smoking 

Can you prevent cataracts?

Although there are no proven scientific methods to avert the occurrence of cataracts, you can implement these ideas to  manage your odds of developing it:

1. Go for regular eye check-ups 

Getting your eyes checked regularly is a sound way to detect eye problems like cataracts at an early stage. Your age and medical history will determine the ideal frequency of your eye examinations. 

Also read: Eye Health: Tips for Maintaining Good Vision

2. Follow a proper diet and lifestyle 

Fruits and vegetables that are naturally rich in antioxidants like vitamins C, E, and A are especially important for maintaining eye health. You may eat fruits like guava, papaya, and oranges for vitamin C, nuts like almonds and peanuts as well as avocados for vitamin E, and green leafy vegetables and liver for vitamin A. Ensure to include a good variety and quantity of fruits and vegetables in your diet for your body to get essential nutrients. Moreover, you may consume nutrition supplements after consulting a doctor. Avoid smoking and excessive consumption of alcohol.

As UV rays may contribute to the risk of developing cataracts, wear sunglasses and hats while going outdoors in the sun.  

3. Keep a tab on your blood sugar level 

Prolonged high blood sugar levels can increase your risk of developing cataracts. If you are diagnosed with diabetes, monitor your blood sugar levels regularly and follow your physician’s advice and treatment plan for managing it effectively.

Although some age-related changes are unavoidable, advanced diagnostic and treatment methods have ensured that you can manage and treat cataracts. While cataracts may not be life-threatening, early detection and lifestyle changes may help before they make life difficult.

References
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2. Cataract. National Eye Institute. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts (accessed Mar 19, 2021).
3. Nizami AA, Gulani AC. Cataract. Treasure Island (FL): StatPearls Publishing, 2021.
4. Cataracts. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/cataracts/symptoms-causes/syc-20353790 (accessed Mar 19, 2021).
5. Diet and Nutrition. American Optometric Association. https://www.aoa.org/healthy-eyes/caring-for-your-eyes/diet-and-nutrition?sso=y#:~:text=Research%20on%20antioxidant%20vitamins%20and%20cataracts&text=The%20Nutrition%20and%20Vision%20Project,the%20progression%20of%20nuclear%20cataracts. (accessed Mar 23, 2021).
6. Boyd K. What Are Cataracts? American Academy of Ophthalmology. 2020; published online Dec 11. https://www.aao.org/eye-health/diseases/what-are-cataracts (accessed Mar 23, 2021).
7. National Blindness and Visual Impairment Survey India 2015-19 – A Summary Report. National Programme for Control of Blindness & Visual Impairment, Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, New Delhi. https://npcbvi.gov.in/writeReadData/mainlinkFile/File341.pdf (accessed Mar 23, 2021).