Is your vision getting a little blurry? Let's talk about cataracts!

Do you sometimes feel like you're looking at the world through a dirty window? Or do you feel like your eyes are getting blue from the headlights when you drive at night? Maybe you need a little more light to read the newspaper. These are not just random things, you may not even know that you have cataracts in your eyes. Don't worry, we'll talk about this in detail today.

Simply put, what are cataracts?

In simple terms, a cataract is a small film, or cloudiness, that forms on the lens inside your eye. Your lens is normally very clear and flexible. It's made up mostly of proteins , specifically proteins called crystallins . As we age, these proteins break down and form what we call cloudy, white spots on the lens. That's what directly affects your vision.

Over time, this condition can worsen and your vision may become even worse. This can make it difficult to do even the most basic daily tasks. Doctors say that cataracts are almost inevitable with age. That's why age-related cataracts are the most common form of this disease.

But don't worry! You don't have to wait for your vision to gradually disappear. Ophthalmologists can perform surgery to remove these cataracts and restore your vision.

Are there different types of cataracts?

Yes, there are several types of cataracts. But in this article, we will mainly talk about cataracts that occur with age. Let's also briefly review the other types:

• Pediatric cataracts: These occur in young babies and children. Some babies can be born with this condition congenitally , or they can develop shortly after birth. Most of the time, these are hereditary. But they can also be caused by eye injuries or other eye diseases. If this condition occurs in young babies and children, it should be treated immediately. Otherwise, problems such as amblyopia , or 'lazy eye', can occur.
• Traumatic cataracts: These develop when your eye is hit by something. Treating these is a bit more complicated because other parts of the eye may also be damaged.
• Secondary cataracts: These are clouding of the lens, not the lens itself, but the lens capsule , the membrane that covers the lens. Another name for this is posterior capsular opacification . This is a common condition that can occur after cataract surgery, but it is easily treated.

What types of problems come with aging?

There are several types of cataracts that develop with age. They are named according to where in the lens they form. To understand this, it is helpful to have a little idea of ​​the Aufbau of your lens.

Imagine your contact lens is like an apple:

• Nucleus: This is located in the center of the lens, like the core of an apple.
• Cortex: This is the layer around the core. It's like the pith of an apple that we eat.
• Lens capsule: This is the thin membrane that covers the cornea. It is not actually part of the lens itself, but it acts as a protective skin around the eye, covering and protecting the lens. It is similar to the skin of an apple.

Eye doctors classify cataracts based on where in the lens they form. Often, people can have more than one type at the same time. This is because it is common for these cloudy spots to form in several places on the lens. The three most common types of cataracts that occur as we age are:

• Nuclear sclerotic cataract: This develops in the center (nucleus) of the lens.
• Cortical cataract: This develops in the cortex.
• Posterior subcapsular cataract: This forms in the back of the lens . "Posterior" here means "behind" the lens. That is, the part closest to your retina (which is behind the lens). "Subcapsular" means that this cataract forms in the outermost edge of the lens, just below the lens capsule.

At what age do cataracts start to appear?

Normally, the proteins in your eye's lens start to break down around the age of 40. But you may not notice symptoms until you are 60 or even later. However, if you have certain diseases, such as diabetes mellitus , you may experience symptoms even earlier.

How common is this situation?

Cataracts are very common in Sri Lanka and around the world. According to the World Health Organization, about 17% of the world's population has cataracts that affect their vision. However, this number varies from country to country and region to region. This is especially true in middle-income and low-income countries. This is because those people have more risk factors and fewer facilities for cataract treatment.

In the United States, 1 in 5 people between the ages of 65 and 74 have cataracts that affect their vision. More than 50% of people over the age of 80 either have cataracts or have had surgery to remove them.

What are the symptoms of cataracts?

If you have cataracts, you may experience symptoms like:

• Vision that appears cloudy, blurred, or foggy .
• Changes in the way colors appear (colors may appear faded or have reduced brightness).
• BrightEyes becoming sensitive to sunlight, car lights, and lamplight.
• Eyes turning blue when looking at light, seeing halos around lights, and seeing streaks.
• Reduced visibility at night .
• A change in your eyeglass prescription, especially a decrease in distance vision and an increase in near-sightedness .
• Needing more light to read.
• Double vision .

Does cataract cause pain?

Cataracts are usually not painful, but you may experience some discomfort as your eyes become more sensitive.

Why do cataracts develop?

The main cause of cataracts is the gradual breakdown of proteins in the lens of the eye. However, certain genetic and environmental factors may increase your risk of developing cataracts at an earlier age or at a later age than others.

What are the risk factors for developing cataracts?

Risk factors for developing cataracts can be divided into three main categories: environmental, medical, and genetic.

Environmental risk factors

These are the things you encounter in the environment around you. Sometimes these can be toxins that you breathe in and ingest. Environmental factors are harmful because they increase the amount of free radicals in your body, which are unstable particles that damage healthy cells. These free radicals can damage the cells in your eye's lens, causing cataracts.

Environmental risk factors are:

• Air pollution.
• Tobacco smoke .
• Alcohol.
• Chemicals released from factories.
• Insecticide.
• Prolonged exposure to ultraviolet rays (UV light) from the sun.
• If you have had radiation therapy to the upper part of your body.

Limiting these environmental exposures may help delay the development of cataracts. Researchers are still investigating how effective these prevention methods are.

Medical risk factors

Medical factors that increase the risk of developing cataracts are:

• Diabetes Mellitus or high blood sugar levels.
• Having undergone certain eye surgeries, such as glaucoma.
• Use of corticosteroids as a treatment for certain conditions (e.g. rheumatoid arthritis).
• Having certain eye diseases, such as Retina pigmentosa or Uveitis .

Genetic risk factors

If someone in your family has cataracts, you are at higher risk of developing them. Certain genetic mutations can cause congenital cataracts. For age-related cataracts, genetic mutations may make your lens more susceptible to environmental risk factors. Researchers are continuing to investigate these links.

So, even though you can't change your genetic risk, it's important to know your family's medical history and share it with your doctor.

How do you know if you have cataracts?

Ophthalmologists and optometrists diagnose cataracts through a comprehensive eye exam. Your doctor will examine your eyes carefully to see if there are any signs of cataracts and how severe they are. They will also ask about your vision, your medical history, and whether your vision is not as good as it used to be, making it difficult to do your daily activities.

Special tests used to detect cataracts are:

• Slit lamp exam.
• Visual acuity test.

What is the best treatment for cataracts?

Cataract surgery is the only way to remove a cataract and restore your clear vision. During cataract surgery, an eye specialist removes your cloudy natural lens and replaces it with an artificial lens (intraocular lens - IOL) . An IOL is an artificial lens that is permanently implanted inside your eye. There are many types of IOLs, and your doctor can talk to you about them.

The main advantage of an IOL is that it is as clear as your natural lens. Another advantage is that it can correct refractive errors , which are other reasons for wearing glasses. This means that you can reduce the need for glasses or contact lenses after surgery.

Is cataract surgery dangerous?

Cataract surgery is one of the safest and most common surgeries performed in the world. Most people do not experience serious complications. However, it is important to be aware of all the possible risks, such as retinal detachment and infection.

Certain eye diseases or other underlying medical conditions can increase your risk of complications. Therefore, you should talk to your doctor about your individual risk level before surgery. Also, ask how any potential problems will be treated.

How long does it take to recover after surgery?

You may feel some pain and discomfort after the surgery. Your doctor will give you painkillers to take for the first day or two.

It takes about four to eight weeks to fully heal, but you will start to notice an improvement in your vision much sooner. Your doctor will tell you when it is safe to resume your normal activities.

What to expect if you have cataracts?

An ophthalmologist or eye doctor can best tell you about your condition. They will examine your eyes and assess the severity of any cataracts you have.

In the early stages, you may not need surgery. The changes in your vision may be minor. But as cataracts grow over time, they can cause more obvious symptoms. If your symptoms start to interfere with your daily life, your doctor may recommend surgery to help you safely continue your normal activities.

Can cataracts be prevented?

Cataracts are a normal part of aging. However, there are a few things you can do to protect your eye health and perhaps delay the process a bit:

• Don't smoke. Tobacco smoke increases the risk of developing cataracts. If you are currently a smoker, ask your doctor for help quitting.
• Protect your eyes from the sun. Wear sunglasses or goggles with anti-UV coating. Wearing a hat with a brim also helps.
• Get regular eye exams. Ask your doctor how often you should come in for exams. Don't miss your exam dates, and tell your doctor if you have any new or changing symptoms.

What can someone with cataracts do to take care of themselves?

If you have cataracts, there are many things you can do to take care of yourself. Here are some of them:

• Wear polarized sunglasses to reduce glare in bright sunlight.
• Use a magnifying glass to help you read.
• To see better while reading, put brighter bulbs in your lamps.
• If the lights make your eyes blue when driving at night, that's okay, but if it's a problem, try to avoid driving at night .
• See your eye doctor according to his schedule and renew your glasses if necessary.
• Keep any underlying medical conditions, such as diabetes, well controlled .

When should I see a doctor?

If you have symptoms of cataracts, or if you notice any changes in your vision, see your doctor. Problems like blurred vision can be a sign of many other eye conditions, including cataracts. Therefore, it is important to see a doctor to find out the cause of your symptoms and get the right treatment.

When should you go to the Emergency Treatment Unit (ETU) ?

Retinal detachmentIf you have symptoms, seek emergency medical attention immediately. This is a rare but serious complication that can occur after cataract surgery. It affects about 1 in 100 people. Warning signs include:

• Suddenly starting to see floaters and flashes of light before your eyes.
• Seeing light with your eyes open or closed.
• The feeling of a shadow or a screen spreading across your vision.

What questions should you ask your eye doctor?

Here are some questions you may want to ask your doctor:

• Do I have signs of cataracts?
• How severe is cataract?
• What type are they and where are they located on my contact lens?
• Will it affect both my eyes?
• When do you think I will need surgery?
• What are the risks for me from the surgery?
• What type of IOL is best for me?
• What can I do to look better until I have surgery?
• What lifestyle changes do I need to make?

Although cataracts are a normal part of aging, receiving a diagnosis of this condition is not always pleasant. The thought of eye surgery can make you feel scared and worried about what your vision will be like after the procedure.

Don't worry too much. Remember, cataract surgery is one of the most common and routine surgeries in the world. You probably know at least one person who has had the surgery, and they may be a good person to talk to about it. Talk to them and ask about their experiences. But don't feel pressured or rushed into having surgery. Talk to your doctor and decide on a time that works best for you.

Finally, things to remember

So, although cataracts are something that comes with age, they are not something to ignore. If you feel like your vision is gradually decreasing, don't panic and see an eye doctor . If detected early, you can get the necessary treatment and live your life normally, with clear vision. It is very important to get eye exams on time and take care of your eyes . Remember, your eyes are the most valuable asset you have to see the world!

` Cataracts, vision impairment, intraocular lens, eye surgery, aging, eye health