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What is a Cataract

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    What is Cataracts?

    Symptoms, Causes &
    Treatment Options
    Cataracts refer to the clouding of the typically clear lens of the eye, causing vision impairment akin to looking through a frosted or fogged-up window. While initially, cataracts may not significantly affect eyesight, they gradually worsen over time, making activities like reading, driving at night, or discerning facial expressions challenging. Initially, remedies like brighter lighting and glasses may suffice, but if vision impairment interferes with daily tasks, cataract surgery becomes necessary. Fortunately, cataract surgery is generally regarded as a safe and effective procedure.

    What is a Cataract?

    A cataract is a condition where the natural lens of the eye becomes cloudy. Normally, inside our eyes, there is a clear lens located behind the coloured part. This clear lens helps focus light on the retina so that we can see clearly. When it turns cloudy, light cannot pass properly, and vision becomes blurred or dull.

    You can imagine it like looking through a foggy glass window. Everything appears unclear and faded.

    Cataract usually occurs slowly over time. In most cases, it is age-related. However, it can also happen in younger people due to injury, diabetes, genetic problems, long-term steroid use, or other health conditions.

    In the early stages of cataract, a person may not even realise there is a problem. Over time, vision becomes blurred, and daily activities like reading, driving, or recognising faces may become difficult.

    A cataract can occur in one eye or both eyes. It does not spread from one eye to another, but both eyes can develop cataracts separately.

    Stages of Cataract

    Cataract develops in stages. The severity of cataract symptoms in the eyes depends on the stage. The speed of progression differs from person to person.

    Immature Cataract

    In this stage, only part of the lens is cloudy. Vision may be slightly blurred but still manageable with glasses. Many people are diagnosed at this stage during routine eye check-ups.

    Mature Cataract

    Here, the entire lens becomes cloudy. Vision becomes very poor. The pupil may look white or grey. Surgery is usually required at this stage.

    Hypermature Cataracts

    If a mature cataract is left untreated for a long time, it can become hypermature. The lens may shrink or leak proteins, which can increase eye pressure (glaucoma) and cause pain. Surgery becomes slightly more complicated.

    Intumescent Cataract

    In this stage, the lens swells due to fluid accumulation. It can cause a sudden rise in eye pressure and needs urgent medical attention.

    Types of Cataracts

    Different Types of
    Cataracts
    Cataracts are classified based on their location and cause.

    Cortical Cataract

    This type of cataract starts at the outer edge (cortex) of the lens. It often starts as white lines or wedge-shaped opacities and slowly moves inward. It often causes glare and difficulty in night vision.

    Nuclear Cataract

    This affects the centre (nucleus) of the lens. It is commonly age-related. Vision may initially improve for near work, but later becomes blurred and yellowish.

    Subcapsular Cataract (Posterior Subcapsular Cataract)

    This type forms at the back of the lens. It progresses faster, affects reading vision, and causes glare. It is common in diabetics and people on long-term steroids.

    Rosette Cataract

    This type of cataract occurs after a blunt injury to the eye. The opacity has a star-like or rosette shape.

    Traumatic Cataract

    Develops after an eye injury, either blunt or penetrating. Traumatic cataract may occur immediately or even years after trauma.

    Black Cataracts

    A rare type where the lens becomes very dark or black. It usually means the lens has hardened and matured over many years. It is usually seen in advanced, untreated cases.

    Blue Dot Cataract

    Small bluish dots appear in the lens. It is often congenital and may not significantly affect vision. It is sometimes caught incidentally during routine exams.

    Christmas Tree Cataract

    In this type of cataract, small, colourful, crystal-like deposits are seen in the lens. It is uncommon and often seen in certain systemic conditions.

    Complicated Cataract

    A complicated cataract occurs due to other eye diseases such as uveitis, retinal disorders, or glaucoma.

    Congenital Cataract

    Present at birth or develops in early childhood. Causes include genetic problems or infections in the mother during pregnancy. Early treatment is very important to prevent permanent vision loss.

    Glass Blowers Cataract

    This type of cataract is seen in people exposed to intense heat and infrared radiation. Historically, it has been seen in people working near furnaces without protection.

    Lamellar Cataract

    It is a type of congenital cataract affecting a particular layer of the lens. It is commonly seen in both eyes.

    Morgagnian Cataract

    An advanced form of mature cataract where the lens cortex liquefies, and the nucleus sinks downward. It needs careful surgical management.

    Oil Drop Cataracts

    The centre of the lens looks like a drop of oil; clear but oddly refractile. It is seen in certain metabolic disorders like galactosemia in children.

    Senile Cataract

    It is an age-related cataract. This is the most common type in India. Vision slowly blurs, glare increases, and colours may look dull over time.

    Snowflake Cataract

    White, snowflake-like opacities are scattered in the lens. Commonly seen in people with uncontrolled diabetes, especially in younger patients.

    Sutural Cataract

    A congenital cataract that affects the sutures of the lens. It usually forms a faint Y-shaped pattern and often does not interfere much with daily vision.

    Types of Cataracts

    Different Types of
    Cataracts

    Nuclear Cataracts

    Blur distant vision initially, with near vision possibly improving temporarily. Over time, the lens turns yellow or brown, impairing vision and color perception.

    Cortical Cataracts

    Initially appear as white spots or streaks on the lens edges, spreading to the center and affecting light transmission.

    Posterior Subcapsular Cataracts

    Start as small spots near the back of the lens, causing glare, halos, and rapid vision deterioration, especially for reading and night vision.

    Congenital Cataracts

    Present from birth or develop during childhood, possibly due to genetic factors or prenatal infections like rubella. Early removal may be necessary if they affect vision.

    Types of Cataract Lenses

    During cataract surgery, the cloudy natural lens is removed and replaced with an artificial lens called an intraocular lens (IOL).

    Each type of lens for cataract surgery has its own advantages. Four common types of cataract lenses include:

    • Monofocal lens: Monofocal lenses provide clear vision at one distance (usually far). Glasses may still be needed for reading.
    • Multifocal lens: Multifocal lenses help in seeing at both near and far distances, but may cause glare in some people.
    • Toric lens: Toric lenses are used in patients with astigmatism. 
    • Extended depth of focus (EDOF) lens: EDOF lenses give a range of vision with less visual problems than multifocal lenses.

    How to Choose the Right Lens for Cataract Surgery

    The choice of the right lens depends on:

    • Age
    • If you want to reduce glasses usage
    • If you have to mostly drive at night
    • If you have astigmatism or diabetes
    • How much do you want to pay
    • Lifestyle needs
    • Expectation about spectacle usage

    Monofocal lenses are commonly used and usually cost less. Multifocal or premium lenses may reduce the need for spectacles, but they are usually more costly. Your eye doctor will help you decide after checking your eye condition and expectations. Not every type of lens suits every patient. 

    Cataract Risk Factors

    Certain factors increase the risk of developing cataract:

    • Age above 50 years
    • Diabetes
    • Smoking
    • Long-term steroid use
    • Excessive sun exposure
    • Family history
    • Eye injury
    • High blood pressure
    • Obesity
    • Excess alcohol intake

    Regular eye check-ups are important, especially for diabetics and elderly individuals.

    Diagnosis and Treatment Options for Cataract

    Cataract Diagnosis

    Cataract is diagnosed by a complete eye examination, which includes:

    • Vision acuity test
    • Slit lamp examination
    • Retinal examination after pupil dilation
    • Eye pressure measurement
    • Biometry for IOL power calculation

    These tests help determine the type and severity of cataract. The procedure is painless and done in OPD.

    Cataract Treatment

    There are no eye drops or medicines that can permanently cure cataracts. The only effective treatment is surgery.

    In the early stages, glasses and better lighting may help. But once vision interferes with daily life, cataract surgery is advised.

    Cataract surgery is one of the safest and most commonly performed surgeries in India. It usually takes 10–20 minutes and is done under local anaesthesia. After a cataract surgery, the patient does not have to stay in the hospital in most cases.

    The eye doctor tells about precautions and expected visual changes before and after cataract surgery to ensure smooth recovery and optimal results.

    The eye doctor also informs about the possible complications of cataract surgery, although serious symptoms of cataract surgery rarely occur if a good surgeon performs the procedure.

    How to Prevent Eye Cataract

    It’s impossible to prevent cataracts, especially age-related ones. However, you can reduce the risk by:

    • Wearing sunglasses to protect from UV rays
    • Controlling diabetes
    • Avoiding smoking
    • Limiting alcohol
    • Eating a balanced diet rich in green vegetables and fruits
    • Regular eye check-ups
    • Avoiding unnecessary steroid use.

    Types of Cataract Treatment

    When it comes to cataract management, the type of cataract surgery depends on the patient’s eye condition, visual needs, and the surgeon’s assessment.

    Traditional Cataract Surgery

    This type of cataract surgery is also called phacoemulsification. In this procedure, a small incision is made in the eyes. The eye doctor breaks the cloudy lens by using ultrasound waves and removes the lens pieces. The surgeon then puts an artificial lens in the eyes. Recovery is usually quick after the cataract surgery, and it does not generally require stitches. The doctor will also explain the temporary restrictions after cataract surgery, such as avoiding eye rubbing, heavy lifting, and water entering the eye for a few weeks.

    Laser Cataract Surgery

    In this type of cataract surgery, a femtosecond laser is used to make accurate incisions and cuts the cataract before removal. But it usually costs more. However, not all patients require laser surgery. The final visual outcome after the cataract surgery depends more on the overall eye condition and lens choice.

    Cataracts FAQs

    Frequently Asked
    Questions
    In young adults, cataract can occur due to diabetes, eye injury, steroid use, genetic conditions, and radiation exposure.
    No. Currently, there is no medicine or eye drop that can remove cataracts permanently. Surgery is the only effective treatment.
    Early-stage symptoms of cataracts include slight blurring of vision, glare from headlights, difficulty in night driving, and frequent changes in glasses.

    Most age-related cataracts start after 50 years of age.

    Major risk factors of cataract include ageing, diabetes, smoking, steroid use, UV exposure, and family history.
    Yes. High blood sugar affects the lens and can lead to early cataract formation.
    No strong evidence shows that normal mobile or screen use directly causes cataract.
    No lens is single “best” for everyone. The choice depends on individual needs.
    Yes, if you do not treat it for a long time, then cataracts can lead to severe vision loss or blindness. Fortunately, surgery can mostly restore vision.
    An ophthalmologist does a detailed eye examination to diagnose cataracts. The eye doctor uses special instruments like a slit lamp and a dilated retinal exam.