Symptoms

Signs and symptoms of cataracts include:

• Clouded, blurred or dim vision
• Increasing difficulty with vision at night
• Sensitivity to light and glare
• Need for brighter light for reading and other activities
• Seeing "halos" around lights
• Frequent changes in eyeglass or contact lens prescription
• Fading or yellowing of colors
• Double vision in a single eye

Since the lens clouding occurs very slowly the vision improves with glasses but slowly as the clouding increases it causes the visual blurring.

Causes

Most cataracts develop when aging or injury changes the tissue that makes up the eye's lens. Proteins and fibers in the lens begin to break down, causing vision to become hazy or cloudy.

Some may be genetic or secondary to other eye diseases such as uveitis.

• The Nuclear Cataract-affects the central part of the lens and may cause nearsightedness.
• The cortical Cataract-The lens fibers start clouding in the periphery and slowly move to the center causing visual disturbance.
• The posterior subcapsular cataract -affects the central back portion of the lens blocking the light entry into the eye. This results in reading and driving difficulty.
• Congenital cataract- may affect newborn or infants. This may be genetic or related to intrauterine infections.s

Risk Factors

Factors that increase your risk of cataracts include:

• Increasing age
• Diabetes
• Excessive exposure to sunlight
• Smoking
• Obesity
• High blood pressure
• Previous eye injury or inflammation
• Prolonged use of corticosteroid medications
• Drinking excessive amounts of alcohol

Prevention: Adapting healthy lifestyles, quitting smoking, eating healthy, regular exercise, wearing sunglasses and regular health checkups may delay the cataract formation.

Diagnosis

• Examination by an ophthalmologist under the slit lamp
• Visual acuity testing
• Tonometry to determine eye pressure
• Retinal examination to rule out other causes of visual loss

When to consider cataract surgery

An eye doctor determines whether surgery is right for you. Cataract surgeries are planned when cataracts begin to affect your quality of life or interfere with your ability to perform normal daily activities, such as reading or driving at night.

A frank discussion between you and your doctor determines when the surgery is needed. Some cataracts progress faster and can worsen faster in people with certain conditions, including diabetes, high blood pressure or obesity.

Delaying the procedure generally won't affect how well your vision recovers if you later decide to have cataract surgery. Take time to consider the benefits and risks of cataract surgery with your doctor.

If you decide not to undergo surgery, your eye doctor may recommend periodic follow-up exams to see if your cataracts are progressing. The doctor determines the frequency of the eye exam.

What happens during cataract surgery

Cataract surgery involves removing the clouded lens and replacing it with a clear artificial lens. The artificial lens, called an intraocular lens, is positioned in the same place as your natural lens. It remains a permanent part of your eye.

In some patients it may not be possible to implant a lens which is determined by the operating surgeon. In such scenarios eye glasses are prescribed.

Cataract surgery is generally done on an outpatient basis, which means you won't need to stay in a hospital after the surgery. During cataract surgery, your eye doctor uses a local anesthetic to numb the area around your eye, but you usually stay awake during the procedure.

Cataract surgery is generally safe, but it carries a risk of infection and bleeding. Cataract surgery increases the risk of retinal detachment.

After the procedure, you'll have some discomfort for a few days. Healing generally occurs within a few weeks.

If you need cataract surgery in both eyes, your doctor will schedule surgery to remove the cataract in the second eye after you've healed from the first surgery.

Refractive surgery:

Refractive surgery can correct refractive errors like nearsightedness, farsightedness, astigmatism, or presbyopia. Some of these surgeries reshape the cornea. Others implant a lens in your eye. Either way, the goal is the same. These surgeries focus light correctly on the retina so you can see more clearly.

The most common refractive surgery is LASIK. Other common surgeries include PRK and SMILE.

Refractive surgery might be a good choice if you:

• Have an appropriate refractive error.
• Want to decrease dependency on glasses or contacts.
• Are free of eye disease.
• Understand and Accept the risks and possible side effects of the surgery.
• You may still need glasses or contacts to see your best.

There is no best method for correcting refractive errors. Talk with your ophthalmologist about your best options after an eye exam. Discuss your specific lifestyle and vision needs. Sometimes the best choice may be to stick with your glasses or contact lenses.