Cataract Surgery
Medical Author: J. Bradley Randleman, MD
Medical Editor: Melissa Conrad Stöppler, MD
What is a cataract?
Cataracts occur when the natural clear lens inside the eye, located behind the iris, becomes cloudy over time. This lens is important for focusing light on the back of the eye (the retina) so that images appear clear and without distortion, and the clouding of this lens during cataract formation distorts our vision. Cataracts are usually a very gradual process of normal aging but can occasionally develop rapidly. They commonly affect both eyes, but it is not uncommon for a cataract in one eye to advance more rapidly. Cataracts are very common, affecting roughly 60% of people over the age of 60, and over 1.5 million cataract surgeries are performed in the United States each year.
Precisely why cataracts occur is unknown; however, most cataracts appear to be caused by changes in the protein structures within the lens that occur over many years and cause the lens to become cloudy. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects. Severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to develop more rapidly. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with cataracts include the long-term use of statins and phenothiazines.
Experts have estimated that in the United States, visual disability associated with cataracts accounts for over 8 million physician office visits a year. This number will likely continue to increase as the proportion of people over the age of 60 rises. When people develop cataracts, they begin to have difficulty doing activities they enjoy. Some of the most common complaints include difficulty driving at night, reading, or traveling. These are all activities for which clear vision is essential.
What are the symptoms of cataracts?
Cataract development is often equated to looking through a dirty windshield of a car or smearing grease over the lens of a camera. Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty with glare (often with bright sun or automobile headlights while driving at night), dull color vision, increased nearsightedness accompanied by frequent changes in eyeglass prescription, and occasionally double vision in one eye. A change in glasses may help initially once vision begins to change from a cataract; however, as the cataract continues to grow, vision becomes cloudy, and stronger glasses or contact lenses will no longer improve sight.
Cataracts typically develop gradually and are usually not painful or associated with any eye redness or other symptoms unless they become extremely advanced. Rapid and/or painful changes in vision raise suspicion for other eye diseases and should be evaluated by an eye-care professional.
Next: How are cataracts diagnosed? »
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