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Cataracts: Overview

What are Cataracts?

There are a lot of myths about cataracts. Generally speaking, they are not visible with the naked eye and not a disease that one contracts. A cataract is actually a clouding of the eye’s natural lens, which lies behind the iris and pupil. If anything, it is a sign that we are living a long and prosperous life! The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see.

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The majority of cataracts are classified as one of three types:

  • A posterior subcapsular cataract begins at the back of the lens. People with diabetes, high nearsightedness or retinitis pigmentosa, or those taking high doses of steroids, may develop a subcapsular cataract.
  • A nuclear cataract is the most common type. This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.
  • A cortical cataract, which forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts.

Symptoms and Signs

A cataract starts out small and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting. A cataract may make light from the sun or a lamp seem too bright. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colors may not appear as bright as they once did.

The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called “second sight.” Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may cause decreased near vision and severe glare interfering with the ability to drive at night.

Cataract Treatment

Initially, it is reasonable to change the glasses prescription if that does an adequate job of improving the vision. If the activities of daily living are affected, however, then cataract surgery may be a better alternative. These activities are the essential ones that people depend on like walking, driving, and reading, for example. This also can include the things that bring everyday joy to our lives like hunting, sewing, or even doing a daily crossword puzzle. Some patients have these difficulties despite having reasonable visual acuities during the eye exam. At Orlando Eye Institute, we prefer to “treat the person, not a number.” Instead of living this way, it is far more preferable to undergo a simple outpatient procedure, cataract surgery, to help drastically improve one’s quality of life. Read more about the different surgical options in our cataract surgery section, including IOL options, refractive laser-assisted cataract surgery (ReLACS), and IOL exchanges.

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