Everything You Need to Know About Cataracts, According to Ophthalmologists
They can start developing as soon as age 40.
Cataracts: They're likely a condition that you've heard of but don't quite know much about—other than how they can make you lose your eyesight, which sounds extremely scary.
But in reality, cataracts are surprisingly common. "Cataracts are like gray hair," Shameema Sikder, MD, an assistant professor of ophthalmology at Johns Hopkins University's Wilmer Eye Institute and director of the Center of Excellence for Ophthalmic Surgical Education and Training, tells Health. "Sooner or later, they will happen to everyone," she adds—in fact, more than half of Americans over 80 either have the eye cloudiness that defines cataracts, or have had surgery to get rid of the issue, according to the National Eye Institute (NEI).
But that still doesn't explain exactly what cataracts are, and what causes them in the first place. To help, Health spoke to ophthalmologists to explain the condition, along with its symptoms and how you can best treat it. Here's what you need to know.
What exactly are cataracts?
Here's the super-simple definition: Cataracts are cloudiness inside the eye. Your doctor can check for them during a (painless) dilated eye exam. "The analogy I like to make is that the lens inside your eye is like an M&M," she says. "When we are born, the lens is sort of like this clear material and as we grow older, it starts to get hazy."
Usually, it's simply age that causes the cloudiness. Around age 40, proteins start to break down and clump, making the lens denser—something you perceive as cloudy vision, according to the NEI.
Aside from age, your risk for cataracts also increases if you have diabetes (and have out-of-control blood sugar), are a smoker, drink in excess, have a family history of cataracts, suffer an eye injury or trauma, spend a lot of time in the sun, or if you take steroids (for something like asthma, for example).
What are the symptoms of cataracts?
Usually, especially early on, cataracts are symptom-free—but as they grow you might notice blurry vision, muted colors (white might seem beige), an inability to see as well at night, a feeling that lights are too bright (contrast sensitivity), seeing halos around lights, seeing double, or you might have to change your eye prescription frequently, according to the NEI.
Another potential sign: "As the lens becomes denser and loses its plasticity over time, we can no longer focus up close and we start to need reading glasses," Kendall E. Donaldson, MD, a professor of clinical ophthalmology and medical director of Bascom Palmer Eye Institute in Plantation, Florida, tells Health.
Patients also often complain of a glare. "People notice this driving at night because of oncoming headlights," says Dr. Sikder. This happens because a denser eye lens can cause light to be scattered as it enters your eye. Even still, others complain that they need more light to read since there's not as much light getting into the eye, says Dr. Donaldson. "It's kind of like a filter on a camera where less and less light gets in," he says.
Over time, and left untreated, cataracts can eventually lead to total vision loss.
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How are cataracts treated—and can you prevent them?
Treatment for cataracts depends on how advanced cataracts are—and whether or not you actually want to treat them. Early on, small changes like using brighter lights or stronger reading glasses or wearing sunglasses can help you manage cataracts.
But, if cataracts are getting in the way of your day-to-day, the definitive treatment is cataract surgery (which is actually one of the most commonly performed surgeries in the US, per the NEI). During the surgery, a doctor removes the cloudy lens and replaces it with an artificial one. "Often I'll tell patients that cataract surgery is basically like we're cracking a circular opening in the candy shell, sucking out the chocolate, then inside that candy shell, implanting a new lens," says Dr. Sikder. The surgery is an outpatient procedure and takes about 15 minutes, she adds.
And while you can't necessarily prevent cataracts, you can protect your eyes, which, at least will delay their onset. According to the NEI, wearing sunglasses and a brimmed hat to block the sun, quitting smoking, eating healthy (hello, fruits and vegetables), and getting a dilated eye exam at least once every two years once you hit 60, can help you keep your eyes as healthy as possible.
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