A cataract is any opacity of the crystalline lens sufficient to cause visual impairment. Cataracts have been known about since the beginning of medical history and are the leading cause of blindness throughout the world. Ninety percent of all cataracts are the result of aging, and usually, there is no other reason for its development. Some loss of lens transparency with age is nearly as inevitable as wrinkling of the skin and graying of the hair. More evidence is mounting that exposure to the sun and its ultraviolet rays may be the cause of this loss of transparency.

The other 10% of cataracts are either congenital (present at birth) or juvenile (early onset) in nature. A large variety of congenital lens opacities exist, but the majority doesn’t cause visual impairment. Juvenile cataracts can occur with congenital rubella, congenital syphilis, diabetes mellitus, and inflammation from an infection. Cataracts can also be caused by trauma to the eye. A blunt injury to the eye may cause the rapid formation of a cataract, or it may develop months or years later.

Visual Symptoms of Cataracts

Many people with cataracts will experience a slowly progressive and painless decrease in vision, whereas others report a rapid loss of vision over a period of months, weeks, or even days. It is not uncommon for elderly patients with cataracts to notice a renewed ability to read without glasses, despite a decrease in distance acuity. This “second sight” is due to a thickening of the lens that changes their eyeglass prescription. Some cataracts will create glare from lights and “halos” while driving at night. It is also not uncommon to experience a loss of color vision. In summary, cataracts can cause loss of vision ranging from very mild to severe impairment. Cataracts alone, however, are not responsible for total blindness.

Treatment of Cataracts

It is important to realize that the cataract itself has little chance of causing other diseases in the eye and that it should be considered only as a visual impediment. In adults, cataract extraction is indicated when visual performance is reduced to an unacceptable level, and there are no other ocular abnormalities. Many times, simply changing the lenses in the glasses can improve vision, and no further treatment is needed. When a prescription change does not improve vision, then one may consider surgically removing the cataract and having a new artificial lens implanted. Today’s procedure does not require the lens to “ripen,” and usually, no stitches are used. If you are concerned about your vision and about the possibility of a cataract, please call for an appointment.

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