A Clear Look at Cataracts

What is a Cataract?

Your eyes have a clear, natural lens made of proteins called crystallins and water. The lens focuses light onto your retina. Over time, the proteins in your eye break down and clump together, causing clouding and a loss of transparency which interferes with the light passing through to your retina. This clouding impacts your vision, making the world look blurry and hazy. Colors seem to fade and you may feel like you are looking at the world through a dirty window.

When we think about cataracts, we tend to default to the most common type, which is associated with aging but there are actually several other types of cataracts:

• Congenital, or pediatric, cataracts are present at birth and can lead to permanent blindness if left untreated
• Trauma-related cataracts are the result of an injury to the eye
• Secondary cataracts are cloudy patches that form on the lens capsule – the membrane that covers the lens – as opposed to on the lens itself. This is a common and easily treatable complication of cataract surgery.

Symptoms of Cataracts

When cataracts first develop, you may not notice any changes in your vision. As the cataract gets denser, symptoms will begin to appear.

Common signs of cataracts include:

• Changes to the color of the pupil – it may take on a white appearance although not generally at the early stages
• Blurred, dim, cloudy, or distorted vision
• Difficulty seeing in low light or at night
• Sensitivity to bright lights and sunlight
• Colors look less vivid
• Lights have glare or halos around them
• Everything starts to look washed out
• Near-sightedness that gets worse
• Needing a brighter light to read
• Double vision

Risk Factors for Developing Cataracts

The most common risk factor for cataracts is one you can’t do much about: the aging process. Around age 40, the proteins in your eye’s lens start to break down. Vision problems usually don’t occur until you are 60 or older. Nearly one in five Americans between 65 and 74 have cataracts that affect their vision and roughly 50% of people over age 80 either have cataracts or have had surgery to remove them.

Other risks include:

• Environmental risk factors. Long term exposure to the sun’s UV light accelerates cataract development – a good reason to wear sunglasses. Other environmental risks include tobacco smoke, air pollution, exposure to pesticides or industrial chemicals, regular alcohol consumption, and having had radiation therapy on the upper part of your body.
• Medical risk factors. Diabetes increases the risk of developing cataracts. Certain eye diseases, such as retina pigmentosa or uveitis also increase risk, as does having to take corticosteroids to treat medical conditions such as rheumatoid arthritis. Past eye injuries or eye surgeries are also risk factors.
• Genetic risk factors. A family history of cataracts elevates your risk of developing them. Some genetic mutations lead to congenital cataracts in infants.

Prevention and Protection

Protect your eyes to delay or prevent the development of cataracts. Drink moderately and quit smoking. To shield your eyes from the sun’s UV light, wear polarized sunglasses and a hat. After the age of 40, have an eye exam every two years until you reach the age of 65 and then, start having one yearly. Update your eye glass prescription as needed. Stay on top of your health issues, especially diabetes.

If you are diagnosed with cataracts, you may not need surgery right away. You and your doctor may determine that some simple accommodations can help:

• Put brighter bulbs in your lamps to help you see better when reading
• Keep a magnifying glass handy to help you read when necessary, such as looking at fine print
• Avoid driving at night if your night vision is declining or if headlights bother you or cause glare and halos

If your cataract symptoms are not interfering too much with daily living, you can postpone surgery. You might just need a new eyeglass prescription to help you see better. When it becomes difficult to complete your regular activities, consider cataract surgery.

Cataract Surgery

Surgery is the only way to remove cataracts and restore clear vision. The success rate is more than 95%, with most people reporting that their vision is significantly improved.

During cataract surgery, your ophthalmologist removes your clouded natural lens and replaces it with a clear, permanent artificial lens called an intraocular lens (IOL). There are many different types of IOLs. Some can even correct refractive errors so that you don’t rely on glasses or contacts as much after you have healed from your procedure.

After your surgery, you may have mild pain and discomfort for several days. You should notice improvements as soon as one to three days after the procedure but full recovery takes four to eight weeks. Your doctor will tell you when it’s safe to return to your usual activities.

This article first appeared in the June 2025 edition of the HealthPerks newsletter.