Cataracts

The natural lens of the eye is normally clear and helps focus light onto the retina. With a cataract, the lens becomes cloudy and less transparent, reducing the quality of the image reaching the retina. Cataracts are common as people get older, although they can also occur earlier because of eye injury, medical conditions, medicines or other factors.

Considering treatment? See our Cataract Surgery page for the procedure, lens options, recovery, risks and cost.

What Are the Symptoms of Cataracts?

Cataracts usually develop slowly. Symptoms can include:

• Blurred, hazy or distorted vision
• Glare or increased sensitivity to bright light
• Halos around lights
• Difficulty driving at night
• Colours appearing faded or less vivid
• Needing brighter light for reading
• Frequent changes to your glasses prescription
• Monocular double vision - double vision that remains when the other eye is covered

Cataracts do not usually cause significant eye pain. If you have sudden loss of vision, severe pain, new flashes or floaters, or a curtain/shadow across your vision, seek prompt eye assessment because these symptoms can indicate another eye problem.

What Causes Cataracts?

Age-related changes in the lens are the most common cause of cataracts. Over time, the lens proteins and structure change, causing areas of clouding.

Factors associated with a higher risk of cataract include:

• Increasing age
• Long-term ultraviolet light exposure
• Diabetes
• Smoking
• Long-term use of some medicines, particularly corticosteroids
• Previous eye injury
• Previous eye surgery such as vitrectomy
• Radiation exposure
• Family history or inherited conditions

At What Age Do Cataracts Develop?

Cataracts mainly affect older adults. They are uncommon in people under 40, and most cataract surgery in Australia is performed in people aged 60 years and over. Age alone does not determine whether treatment is needed - the important question is how much the cataract affects your vision and everyday activities.

Different Types of Cataracts

Nuclear Sclerotic Cataract

A nuclear cataract develops in the central part of the lens. The lens may gradually become more yellow or brown and distance vision can become increasingly blurred. Some people experience a temporary shift toward short-sightedness, sometimes called 'second sight', before the cataract progresses further.

Cortical Cataract

A cortical cataract develops in the outer layers of the lens and can form spoke-like areas of clouding that extend toward the centre. Glare and difficulty with contrast or night vision can be prominent symptoms.

Posterior Subcapsular Cataract

A posterior subcapsular cataract develops near the back surface of the lens. It can cause glare, difficulty reading and reduced vision in bright light. This type can occur in younger adults and is associated with factors such as corticosteroid use, diabetes, eye injury and radiation exposure.

Congenital and Developmental Cataracts

Some cataracts are present at birth or develop during childhood. Small cataracts may have little effect on vision, while visually significant cataracts can interfere with normal visual development and may require early specialist treatment. A white or unusual pupil in a baby or child should be assessed promptly because cataract is only one of several possible causes.

Traumatic Cataract

Eye injury can damage the natural lens and lead to cataract. A traumatic cataract may develop soon after the injury or gradually over time.

How Are Cataracts Diagnosed?

An optometrist or ophthalmologist can assess whether a cataract is present and whether it is likely to be responsible for your visual symptoms. Assessment may include:

• Visual-acuity testing
• Refraction to check your glasses prescription
• Slit-lamp examination of the lens and front of the eye
• Dilating eye drops to examine the retina and optic nerve
• Eye-pressure measurement
• OCT or other imaging if another eye condition may also be affecting vision

Do Cataracts Always Need Surgery?

No. In the earlier stages, cataract symptoms may sometimes be managed with updated glasses, brighter lighting, anti-glare measures or other visual aids. Surgery is generally considered when the cataract interferes with activities that matter to you, such as driving, reading, work, hobbies or independent daily living.

When surgery is the right step, our Cataract Surgery page explains phacoemulsification, laser-assisted surgery, IOL options, recovery and cost.

Can Cataracts Be Prevented?

Cataracts cannot always be prevented, particularly age-related cataracts. However, general eye-health measures may help reduce avoidable risk:

• Protect your eyes from ultraviolet light with appropriate sunglasses and a hat
• Do not smoke
• Manage diabetes and other medical conditions with your healthcare team
• Use prescribed steroid medicines only as directed and attend recommended eye checks when long-term treatment is required
• Use appropriate eye protection during activities that could cause eye injury

When Should I See a Cataract Specialist?

Arrange an eye assessment if blurred vision, glare, night-driving difficulty, colour changes or frequent prescription changes are affecting your daily life. A cataract specialist can confirm whether cataract is the main cause of your symptoms, identify other eye conditions and explain whether observation, updated glasses or surgery is appropriate.

Book a Cataract Assessment

If you are noticing cataract symptoms or have been told you have cataracts, an assessment can help you understand the stage of the condition and the treatment options available. Book an appointment with personalEYES or call 1300 68 3937.