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What are cataracts?

Cataracts are changes in the lens of the eye that adversely affect vision. The lens, a lentil-shaped organ behind the colored part of the eye, helps focus light rays on the retina, which lines the back of the eye and relays images to the brain.

When the transparent lens loses its flexibility and becomes cloudy — as it almost inevitably does with age — vision can deteriorate. About 80 percent of older people have age-related lens changes; almost half of that group experiences the resulting vision problems.

What causes cataracts?

The normal aging of the eye is responsible for most cataracts. With age, dense, cloudy patches called opacities develop in the lens. These are referred to as degenerative cataracts. Age, likewise, robs the lens of some of its ability to change shape

in order to focus clearly. Cataracts can also be caused by diabetes, as well as injuries in which the eye is punctured, and a condition called uveitis, which is marked by inflammation of the eye. Steroid drugs such as cortisone can, over time, contribute to the development of cataracts, as can exposure to x-rays, microwaves, and infrared light. Strong doses of ultraviolet light, such as those delivered in commercial tanning booths, may also contribute to the development of cataracts.

Lens clouding that develops early in life and is due to congenital or hereditary causes is referred to as a developmental cataract.

How are cataracts diagnosed and treated?

A doctor can detect advanced cataracts by looking through an ophthalmoscope, the instrument used to examine the interior of the eye. To determine what part of the lens is affected or to detect less severe cataracts, the eye must be examined through a slit lamp, which emits a ray of intense light through a narrow aperture. The doctor may administer eye drops to dilate

the pupils before the slit lamp examination.

If the cataract is not advanced, the doctor may merely prescribe new glasses and schedule regular follow-up visits to monitor any changes. More advanced cataracts may be surgically removed.

What can I do myself?
Take note of any change in vision and see a doctor before your eyes adapt to the change and it becomes less bothersome. If you have diabetes or other conditions that promote cataract development, have your eyes checked regularly and follow your doctor's regimen for treating the underlying condition. Avoid exposing the eyes to bright sunlight or ultraviolet rays and wear protective goggles when welding or doing any type of work that exposes the eyes to flying debris.

When should I see my doctor?
After age 40, you should have a yearly eye exam as part of your routine health care. See a doctor immediately for any sudden changes in vision.

What will the doctor do?
The doctor will determine the severity of the cataracts and, on the basis of the patient's overall health, decide whether surgery is advisable. If other eye problems are present, cataract surgery may not be the best course of treatment.

their long-term effects are not known.) Alternatives to an implant include special glasses or contact lenses. Most cataract surgery requires no hospital stay, but several weeks are needed before improvements in vision are fully realized.

The course of cataracts

Cataracts grow worse over time, but the rate of deterioration varies from person to person. After surgery, 97 to 98 percent of patients experience significant improvement. Surgery is recommended when the cataracts reach a point where they significantly impair vision. The precise stage at which this occurs depends a good deal upon how the eyes are used. For example, a photographer or artist may elect to have surgery earlier than someone who is not as dependent upon visual acuity. Age is not a contraindication to this type of surgery. People in their 90s safely undergo cataract operations.

Are cataracts dangerous?
Cataracts are not a threat to physical health, but they can eventually cause blindness. Hence, it is important to have a physician monitor their progress and initiate treatment at the appropriate time.