Cataracts

Cataracts become an increasingly likely concern as we age. More than half of Americans 80 years and older have cataracts or have had cataract surgery, according to the National Eye Institute. Our team at The University of Kansas Health System has performed thousands of cataract procedures, most of which are done right in our offices on an outpatient basis.

Cataracts are when the clear lens of the eye becomes cloudy and impairs your vision. This happens because of certain proteins that build up on the lens.

Cataracts can develop in 1 or both eyes. Even when cataracts affect both eyes, each eye can be impacted differently. Cataracts are progressive, which means they worsen over time. However, the speed at which cataracts develop can vary from person to person. Cataracts can also develop at different speed from eye to eye in the same person.

The most common cause of cataracts is aging. Age-related cataracts tend to develop slowly. However, people can also develop cataracts as the result of another health condition, such as diabetes or an injury to the eye. These types of cataracts can occur at any age. Cataracts in younger people tend to progress more quickly than age-related cataracts in older people.

Cataracts can also develop at different speeds from eye to eye in the same person.

There are several different types of cataracts that can impair vision. Cataracts are categorized by where they develop on the lens:

• Cortical cataracts develop around the edges of the lens
• Nuclear cataracts affect the center of the lens
• Posterior subcapsular cataracts begin at the back of the lens

Not all cataracts are age-related. Congenital cataracts are a type of cataract that you’re born with. This can happen due to an intrauterine infection during pregnancy or may be genetic. Congenital cataracts don’t always impair vision.

The specific set of symptoms you experience indicates the type of cataracts you have.

• Changes in the way you see color, such as colors looking faded or yellow
• Double vision (seeing 2 images instead of 1)
• Increased sensitivity to light
• Needing frequent prescription changes for glasses or contacts
• Needing more light for tasks that require more visual precision, like reading
• Poor night vision, or seeing halos around lights at night
• Vision that’s blurry, cloudy or dim

The specific set of symptoms you experience indicate the type of cataracts you have. For example, cataracts that start at the back of the lens form right in the path of light entering the lens. This causes night vision issues like halos around bright lights, a visual disturbance that might not be present when cataracts are in a different area of the lens.

Although cataracts develop as a normal part of aging, other genetic and environmental factors can increase your risk of developing cataracts:

• Chronic exposure to ultraviolet rays from the sun
• Diabetes
• Excessive alcohol use
• Eye injuries, inflammation or surgery
• High blood pressure
• Obesity
• Smoking

Cataracts can be diagnosed at a regular eye exam as part of your routine eye care. Your eye doctor may perform one or more tests to determine the presence and location of cataracts, as well as gather other information that will help determine the best approach to treatment:

• Retinal exams begin by dilating the pupil so your doctor can see the back of the eye and potential signs of cataract more clearly.
• Slit-lamp exams help your doctor find lens abnormalities.
• Visual acuity tests measure how well you can see at varying differences. This is usually done by having you read letters of different sizes off a chart.

Your eye doctor may perform other cataract screening tests as well.

Early cataract treatment focuses on improving the symptoms of cataracts without surgery. Nonsurgical treatments to correct poor vision from cataracts include:

• New glasses or contacts prescription
• Using magnifying glasses for finely detailed work
• Working with stronger lights when performing detail-oriented tasks

Your eye doctor may also suggest options for slowing down the progression of your cataracts, such as wearing a hat or sunglasses outside to protect your eyes from UV exposure.

If cataracts progress to the point of interfering with day-to-day life and activities, your doctor may recommend cataract surgery. Cataract surgery is one of the most common surgeries performed in the world. Typically performed as an outpatient procedure, most people can go home right after cataract surgery.

During cataract surgery, your eye doctor will remove the affected lens and replace it with an artificial lens. If cataracts are present in both eyes, your eye doctor will usually perform surgery on one eye and wait for healing to complete before performing surgery on the other eye.