In our ongoing series for #VisionHealthMonth, our focus in today's blog is on a common age-related concern: Cataracts.
Cataracts are a part of the normal aging process and are most often found in those over the age of 60. According to the Canadian Association of Optometrists. when the proteins in the lens of the eye are disrupted and break down, it causes the lens to become cloudy leading to a cataract. This clouding of the lens in the eye affects a person's vision and can occur in either or both eyes. It cannot spread from one eye to the other.
Cataracts can develop slowly over many years or rapidly progress over a few months. In Canada, when a cataract is “ripe”, it can be easily treated with cataract surgery.
What is the Lens?
The lens is a clear part of the eye that helps to focus light, or an image, on the retina. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The retina is the light-sensitive tissue at the back of the eye. In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain.
The lens must be clear for the retina to receive a sharp image and adjust the eye's focus. If the lens is cloudy from a cataract, the image you see will be blurred.
Types of Cataracts
Although most cataracts are related to aging, there are other types of cataracts:
Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
Radiation cataract. Cataracts can develop after exposure to some types of radiation.
What Causes Cataracts?
The lens is made of mostly water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.
Researchers suspect that there are several causes of cataracts, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.
Other causes of cataracts include:
UV damage - Prolonged UV light damage from not wearing sunglasses while being outdoors is a common cause of cataracts.
Trauma - Trauma to the eye including injuries, surgeries or radiation treatments can cause cataracts.
Systemic conditions - Systemic conditions such as diabetes can cause cataracts as a buildup of sorbitol results in the cloudiness of the lens. Individuals with diabetes should keep tight blood sugar control. Other systemic conditions that can cause cataracts include hypertension, obesity, chronic kidney disease, and autoimmune disease.
Certain medications - Certain medications can cause cataracts to develop early, such as corticosteroids, chlorpromazine, amiodarone, and phenytoin.
Congenital conditions - In some cases, people are born with cataracts. These are called congenital cataracts. They may be inherited or result from an underlying health condition.
How do Cataracts Affect an Elderly Person's Vision?
Cataracts may affect vision in the following ways:
Blurry or foggy vision (for example it feels like there is a film covering the eye that does not go away with repeated blinking)
Double vision or multiple images in one eye (This symptom may clear as the cataract gets larger)
Halos or ghost images
Dull or faded colour vision
Increased sensitivity to light and glare (for example to sunlight or oncoming headlights)
Poor night vision
Trouble seeing and reading at night (You need extra lighting)
Frequent prescription changes in your eyeglasses or contact lenses.
These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.
Prevention
According to the Canadian Association of Optometrists, wearing UV protective glasses has been shown to be helpful in slowing down the development of cataracts. In individuals with diabetes, it is important to maintain tight blood sugar control. Some research evidence suggests taking antioxidants may be helpful in preventing cataract progression. Examples of antioxidant-rich food are berries, beans, pecans, prunes, and dark green vegetables. Quitting smoking may also prevent cataract development as smoking has been linked to cataracts.
Cataracts are diagnosed with an eye exam. Visit your optometrist for your routine eye exams. If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataracts, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.
How Cataracts are Diagnosed
A cataract is detected through a comprehensive eye exam that may include:
Visual acuity test. This eye chart test measures how well you see at various distances.
Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.
Your eye care professional also may do other tests to learn more about the structure and health of your eye.
Cataract Treatments
The symptoms of early cataracts may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, your optometrist will refer you to an ophthalmologist who may recommend surgical removal of the cataracts. Find out more on how to prepare for cataract surgery.
In Canada, cataract surgery is one of the most common surgical procedures performed. It is an effective low-risk procedure. The process involves removing the cloudy lens from the eye and replacing it with a new clear lens implant. Generally, the lens implant will provide you with clear distance vision. Your near vision may still be blurry and will likely require reading glasses. Visit your optometrist one month after surgery to obtain your updated glasses prescription.
If you or your loved one is experiencing any signs or symptoms of Cataracts or other vision changes, please visit your optometrist right away.
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