Frequent changes to glasses
A prescription that keeps changing, or new short-sightedness in later life, can be an early sign that the lens is clouding.
Cataracts
What a cataract is, how it changes your vision, and when it is worth talking about surgery.
What is a cataract?
The lens sits just behind the coloured part of the eye and focuses light onto the retina. With time it can lose its clarity, like a window that slowly fogs.
A cataract is that clouding of the natural lens. It is one of the most common causes of gradually worsening vision, usually developing over years rather than weeks, and it can affect one eye or both. It is not a growth or a film on the surface of the eye, and it cannot be cleared with drops or exercises.
Because the lens sits in front of the retina, a cataract can also make the back of the eye harder to examine. In a practice that spans both, the assessment looks at the whole eye before any decision is made.
How cataract care works here →In brief
- Very common with age, and sometimes earlier
- Develops slowly; vision changes are gradual
- Can affect one or both eyes
- Glasses help at first, then stop helping
- Surgery is the only treatment that removes it
How vision changes
Symptoms of cataract.
As the lens becomes less clear, light scatters on its way to the retina. The result depends on where the clouding sits.
ClearWith cataract
Blurred vision
Detail softens, as though you are looking through a foggy window. Landmarks and signs lose their edges.
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Glare and haloes
Rings or starbursts around headlights and streetlights, especially when driving at night.
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Faded or yellowed colours
Colours look duller, less vibrant or slightly yellow-brown, so bright food and greenery look flat.
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Poor night vision
Dim rooms and evening light become harder to see in, and more light is needed to read a menu or a face.
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Double or ghosted images
A shadow or second image in one eye, even with the right glasses, so faces and print look doubled.
Slide each picture to compare clear vision with a typical cataract. Illustrations are indicative, not a diagnostic test or a prediction of vision after treatment.
Why cataracts form
Age is the main cause. It is not the only one.
Ageing
Most cataracts are age-related and appear gradually from the sixties onward, sometimes earlier.
Sunlight and UV
Australian UV levels are among the highest in the world. Sunglasses and a hat help protect the lens over a lifetime.
Diabetes and general health
Diabetes and some other conditions can bring cataracts on earlier.
Medications
Long courses of steroid medication are a recognised cause.
Injury or previous eye surgery
Trauma and some retinal operations, including vitrectomy, can accelerate a cataract.
Smoking
Smoking is linked with earlier cataract, and stopping helps eye health in general.
General information. Individual risk is discussed at the consultation.
Living with a cataract
Can I slow it down?
Nothing reverses a cataract, but a few habits are worth keeping.
- Protect your eyes from the sun. Wraparound sunglasses that meet the Australian standard, and a broad-brimmed hat.
- Look after general health. Good control of diabetes and blood pressure supports the eye as well.
- Do not smoke. Smoking is linked with earlier cataract and with macular disease.
- Keep glasses up to date. An early cataract can often be managed with a prescription change for a while.
A quiet word on supplements
No tablet, drop or diet has been shown to clear a cataract once it has formed. A balanced diet is good for the eye, but it is not a treatment.
Deciding about surgery
When is it time to think about surgery?
There is no single measurement that says now. The decision rests on how much your vision is affecting your day.
Difficulty driving, particularly at night, trouble reading or recognising faces, glare in bright sun, or a prescription that no longer helps are the usual prompts. Visual requirements for driving are also part of the conversation for many people.
Very dense cataracts can make the operation more demanding, so timing is worth discussing rather than leaving until vision is severely affected. Equally, there is no need to rush surgery for a mild cataract that is not bothering you.
What cataract surgery involves →Bring to your appointment
- Your current glasses
- A note of what is hardest to do
- Any eye history or previous surgery
- A list of medications
Common questions
Straight answers, without replacing a consultation.
Can a cataract be treated with drops or laser?
No. The only treatment that removes a cataract is surgery, where the cloudy lens is replaced with a clear artificial lens. Laser is used later in a small number of eyes if the membrane behind the new lens becomes hazy.
Does a cataract have to be ripe before surgery?
No. That idea belongs to older surgical techniques. Today the question is whether the cataract is affecting your life, and whether the eye is otherwise healthy.
Will I go blind if I wait?
Cataracts progress slowly and waiting for a while rarely harms the eye. Very advanced cataracts can make surgery more complex, so the timing is a conversation rather than an emergency.
Can I still drive?
That depends on your vision with your current glasses and on the standards that apply to your licence. It is one of the practical questions addressed at the consultation.
Do cataracts come back?
No. The artificial lens does not cloud. Some people later develop haze on the capsule behind the lens, which can be cleared with a brief laser treatment.
Ready when you are.
Appointments and enquiries through Vision Eye Institute, Chatswood.
Free Chinese Patient Liaison for VEI Sydney patients. Chinese language support through VEI (02) 9052 1886