A cataract is simply the clouding of the lens in the eye. When the lens becomes cloudy, the flow of light is distorted and the picture formed on your retina becomes dim or blurry.
Cataracts are common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. A cataract can occur in either or both eyes. However, it cannot spread from one eye to the other.
In addition to the obvious problems of reduced vision, the visual disability associated with cataracts can have a significant impact on the risk of falls and fractures, your quality of life, and possibly even mortality.
Types of cataracts: Although most cataracts are related to aging (age-related cataract), there are other cataract types. Some of these include:
Secondary Cataracts: Secondary cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts can also develop in people who have other health problems, such as diabetes. Cataracts have even been linked to steroid use.
Traumatic Cataracts: A traumatic cataract can develop after an eye injury, sometimes years later.
Congenital Cataracts: Some babies are born with cataracts or develop them in childhood, often in both eyes. These congenital cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
Radiation Cataracts: Radiation cataracts -- as you might expect -- can develop after exposure to certain types of radiation.
There are several possible cataract symptoms. However, other eye problems can also cause these symptoms. Anyone with possible symptoms should see an eyecare professional. Only a qualified eyecare professional can diagnose and treat the problem.
Possible symptoms may include:
Lights seem very bright (glare).
Colors seem faded.
Poor night vision.
Double vision or multiple images in one eye (this may go away as the cataract gets larger).
Frequent prescription changes in your eyeglasses or contact lenses.
Blurred or cloudy vision.
Causes and Risk factors:
A cataract occurs when the lens inside your eye becomes cloudy. Factors associated with clouding include:
Overexposure to ultraviolet (UV) radiation, such as from sunlight, tanning booths, or sunlamps.
Diabetes, especially when the blood sugar levels are above the safe range, causes changes in the eye that can result in cataracts.
Disease inside the eye, such as glaucoma, long-term (chronic) uveitis, retinitis pigmentosa, or retinal detachment.
Long-term use of steroid medicines.
Frequent X-rays or radiation treatments to the head.
Family history (genetics). A person may inherit the tendency to develop cataracts.
Vitrectomy: People older than age 50 who have had the vitreous gel removed from their eye (vitrectomy) have an increased risk of cataracts. Some studies show that up to 80% of older people develop cataracts between 6 months and 3 years after vitrectomy.
Eye injury. Even though injury-related cataracts are rare, injury is a leading cause of cataracts in children.
Being born with cataracts (congenital). Some children are born with the condition.
Aging (age-related cataracts).
Research scientists know how the lens clouds (see Age-Related Cataract Formation) and that certain things can increase a person's risk of developing cataracts. But researchers do not know what causes the lens to cloud. The search for these cataract causes is an active area of research.
Cataract research has shown that people with certain risk factors are more likely than others to develop them. A risk factor is anything that increases a person's chance of developing a disease.
Specific risk factors for this condition include:
Long-term alcohol use.
Prolonged exposure to ultraviolet sunlight.
Age (the risk increases as you get older).
Cataracts are most commonly detected using examinations involving pupil dilation, a visual acuity chart, or tonometry. At times, two or more of these tests may be used in combination for the most accurate cataract diagnosis. Although cataract detection may be slightly uncomfortable, diagnosis by a qualified doctor is the first step toward restoring crisp, clear vision.
Pupil Dilation: Pupil dilation is a common test used in cataract diagnosis. First, the ophthalmologist uses eyedrops to widen your pupils so that he or she can see the back of your eye. It will take 15-20 minutes for your pupils to dilate fully. Then the doctor will ask you to stare straight ahead as each eye is examined with a bright light and special lens. Dilating the pupils allows the ophthalmologist to examine the lens and retina for eye diseases. The doctor may apply pressure to your eyeball through the surrounding skin with a blunt instrument. Although this procedure is somewhat uncomfortable, it is not painful. Pupil dilation can leave your vision blurry and sensitive to light for a few hours after the test. It is best to have sunglasses on hand and make arrangements to be driven home after you leave the doctor's office.
Visual Acuity Test: In the most well-known vision test, the visual acuity test, the doctor will ask you to read letters or symbols of various sizes from a chart. The eyes will be tested individually and together to measure the accuracy of your eyesight at different distances. This test is frequently used to screen for any visual problems, including cataracts. The visual acuity test provides easy, painless, and quick cataract diagnosis. More tests may be necessary before your doctor can be sure that cataracts are causing your vision problems.
Tonometry Test: A tonometry test can determine whether or not you have a cataract by measuring the fluid pressure inside of your eyes. The doctor will first numb the surface of your eyes using eyedrops. An instrument will be used to place a small amount of pressure on your eye. In some cases, your eye is not touched at all and a puff of air is directed at it instead. Results of this test are most accurate when the patient is relaxed, has not had alcohol for 12 hours prior to the test, has not smoked marijuana for at least 24 hours, and has not had more than two cups of fluid in the past four hours. This test is not painful and only mildly uncomfortable. In addition to providing a cataract diagnosis, the test will also be able to detect signs and symptoms of glaucoma.
Effective treatment cannot begin until a cataract diagnosis is made by a qualified eye doctor. Vision problems should be detected before advanced cataract stages of development begin. Determining that cataracts are the source of your vision problems is the first step toward restoring healthy vision.
Currently, surgery is the only effective method of treating vision loss caused by cataracts.
Cataract surgery is a common procedure that involves removing the clouded lens of the eye (the cataract). The lens makes it possible for the eye to focus. The lens can be replaced with an artificial lens called an intraocular lens implant (IOL), or it can be left out and eyeglasses or contact lenses can compensate for its absence. For more information about IOL implants, see intraocular lens to replace the natural lens of the eye.
Surgery is often not necessary or can be delayed for months or years. Many people with cataracts get along very well with the help of eyeglasses, contacts, and other vision aids.
The choices for treating cataracts in children depend on how likely the cataracts are to interfere with development of normal vision.
Whether surgery is needed for an adult with cataracts depends on the degree of vision loss and whether it affects quality of life and ability to function.
Misconceptions about cataracts are common. In recent years, an increasing number of medical facilities have been built specifically for cataract surgery. Marketing campaigns aimed at older adults may encourage some people to have surgery when they do not really need it. Because of fear of blindness or loss of independence, older adults may think they need to have surgery even when their cataracts do not affect their quality of life. In many cases, wearing eyeglasses or contacts and using other vision aids might be appropriate and just as effective without any of the risks of surgery.
Other Treatment Choices: Tips for improving vision include repositioning room lights and keeping your eyeglasses prescription current.
Low-vision accommodations in your home range from adding adequate lighting to adjusting carpets and furniture to avoid potential hazards.
Low-vision aids and adaptive technologies include video enlargement systems and speech software for computer systems.
Vision aids can be used for a short time, while you are deciding on surgery, or on a long-term basis, to avoid surgery.
Surgery may be advisable if you want to continue to drive a car. If you live in a retirement home or assisted-living facility, you may decide to use vision aids and avoid surgery.
Medicine and medications:
Medication Choices: Mydriatic eyedrops.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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