During an examination the other day, a patient joked with me, "Doc, I hope I don't have any Cadillacs in there-- I only drive Fords." I assured him that not only did he not have any signs of cataracts, I also saw no evidence that anyone had parked their car in his eye.
Most people have at least heard of cataracts, but many perhaps don't understand exactly what they are.
We all have a small lens within our eye, that sits just behind the iris (the colored part of your eye). This lens is crystal clear when we are born, but due to ultraviolet exposure and time, it begins to slowly cloud and change color. At some point, this lens may become cloudy enough that it is detectable to your eye doctor, and may begin to cause changes in vision. We call the reduced transparency of this lens a cataract.
Early cataracts may not cause any vision changes, although some people may notice changes in night vision or difficulties with glare. All cataracts are progressive, and at some point, the lens within the eye will become cloudy enough to seriously restrict vision. At this point, cataract surgery may be necessary. Most times, the patient will know when the surgery is necessary or at least desirable. Common symptoms of cataracts include cloudy or blurry vision, problems with light, such as headlights that seem too bright, glare from lamps or very bright sunlight, colors that seem faded, and double or distorted vision. Early cataracts may not cause any vision changes, although some people may notice changes in night vision or difficulties with glare.
Most visually-significant cataracts occur in the 7th decade of life and are slowly progressive. There are certain other types, typically associated with trauma or steroid use that may occur earlier in life and progress very quickly. Steroid nasal sprays are often the culprits of causing these fast-growing cataracts.
While nothing can prevent cataracts (in fact, everyone may need cataract surgery eventually if they live long enough), there are a few things you can do to slow their growth. For one, limit ultraviolet exposure. This means glasses or sunglasses with 100% UVA and UVB protection. A hat with a brim does a lot of good as well. In addition, smoking contributes to increased cataract formation, so quitting smoking will slow the progression of cataracts.
Next time, I'll talk about the process of cataract surgery, how to know if you are a candidate, and what to expect before, during, and after surgery.