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One of the more common questions that comes up in our office is "What are cataracts?"  They are one of the more common things we see in practice, and generally are one of the most treatable forms of vision impairment.

Cataracts 101: What exactly are cataracts?

Inside the eye, there is a natural lens that allows us to focus.  When we are younger, it even changes shape a little to allow us to change focus from distance to near and back again.  As we age, that natural lens becomes yellow and cloudy.  When your optometrist looks in your eye, he or she can see the clouding of the lens and diagnose the cataract.  There are actually a few different forms of cataract, meaning different patterns in which the clouding can happen.  Sometimes people can have a mix of multiple types.  The most common is nuclear sclerosis, which is that natural, all over, yellowing of the lens.  Cortical form just like spokes on a bike, starting at the edge of the lens and pointing to the middle.  Posterior subcapsular (PSC) form on the back surface of the lens, usually right in the middle of your vision.

Cataracts 101: What are the symptoms of cataracts?  How do I know I have them?

Early cataracts may not have any symptoms.  We expect to see some normal aging changes in the lens starting anywhere after age 40.  Typically they progress very slowly, over many years.  The first symptoms to usually show up are glare, especially at night.  The clouding of the lens causes light to scatter in the eye more, which is what makes glare so much worse.  Color vision can also be affected.  Eventually when the cataracts are mature, your vision will be blurry no matter what glasses or contact lenses are prescribed.  It is like looking through a dirty window.

Cataracts 101: What can be done about cataracts?

Some things can make cataracts worse sooner.  These include certain medications (systemic steroids being a prime example), diabetes, and smoking.  Eventually everyone does get cataracts no matter what they do.  When they are mature enough that they are impairing vision to a certain level, they are surgically removed.  There are many new techniques that have been developed even within the last few years, including the use of lasers.   When it is time for the cataracts to come out, an ophthalmologist will make small incisions at the edge of the cornea (the front clear part of the eye), break up the natural lens inside the eye, and remove it.  An artificial lens is then inserted in its place.  One of the nice benefits of cataract surgery is that the artificial lens can be used to correct your vision, at least at distance.  Some lenses can even correct vision at distance and near, reducing your dependence on glasses significantly.  As with any surgery, cataract surgery has its risks, which are important to discuss with your doctor.




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