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A Guide to Identifying Cataracts: Early Signs & Symptoms

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There are several eye conditions that can cause blurry or foggy vision, dimming of lights or colors, sensitivity to light, and trouble with night vision, and cataracts are one of these. This disease occurs when damaged proteins in the eye’s lens begin to clump together, causing problems with how light refracts onto the retina of the eye, ultimately distorting the picture your brain processes..

While cataracts are a progressive disease that can cause blindness when they are untreated, they are easy to diagnose and treat in the United States. After your vision is significantly obscured, you will be recommended for surgery, but this could take years after you are initially diagnosed with cataracts.

young woman with cataracts

But how will you know that you have cataracts? What do they look like? There are several symptoms, but in the early stages, they may seem like several other eye conditions. You may feel like your glasses or contact lenses are constantly dirty, and you may need more light to read. You may need to wear sunglasses more often to reduce glare, or you may begin to feel unsafe driving at night. You may need much higher prescriptions for glasses or contact lenses all of a sudden. These symptoms may not be noticeable to you, but if you get regular eye checkups, your doctor will notice the problem and work to understand what is going on with your eye.

This article can help you identify and report symptoms that may be cataracts or another eye condition, so you can get the best treatment to slow the disease’s progression.

What Are Cataracts and What Are the Different Types?

Cataracts are a condition that obscures the lens of the eye, ultimately preventing light from refracting through it and onto the retina. Trauma to the eye, illness in the eye, disease or trauma to a fetus in utero, or simply age can all lead to the development of cataracts. Essentially, anything that breaks down proteins in the lens, leading them to clump together, will cause cataracts.

This problem may start small and be hardly noticeable, but if left untreated, cataracts will lead to blindness. In the United States, half of all older adults will either have cataracts or have undergone cataract surgery to remove this condition and improve visual acuity by the time they are 80 years old.

There are a few different types of cataracts, depending on how proteins clump together. The type of cataract that forms may change the symptoms of the cataract.

  • Nuclear: A clump of proteins forms in the center of the lens and slowly spreads out over time.
  • Cortical: The opposite of a nuclear cataract, this type forms as streaks on the edge of the lens and spreads inward.
  • Posterior capsular: Clumps or spots form on the back of the capsule containing the lens. These are the fastest-forming cataracts, and they are more likely to occur in people who are younger than 40 years old.

Causes of Cataracts

Cataracts are primarily caused by aging, and it mostly affects 50% of white Americans who reach the age of 75. During the aging process, some of the protein in the lens clumps and clouds sections of your lens.

The resulting clouding of your lens, which makes it seem like you are looking through fog, is the characteristic sign of a cataract. Other causes of cataracts include:

  • Medication particularly steroids
  • Previous eye surgery
  • Medical conditions like diabetes
  • Eye injuries
  • Radiation

Symptoms of Cataracts Will Be Barely Noticeable in the Earliest Stages

old man with vision problems

When you develop cataracts, there are several symptoms that may appear, but in early stages, these may be irregular, mildly annoying, or mimic an existing condition like a refractive error. Most cataracts develop slowly, so the symptoms may progress in ways that you get used to easily. If you do not get regular eye exams so an optometrist or ophthalmologist can keep track of your vision changes, then you may experience serious symptoms before you get appropriate treatment.

It is important to know signs of a developing cataract and what they look like, so you can ask questions and get help from eye doctors who can diagnose your symptoms appropriately. The most reported symptoms of cataracts include:

  • Blurry or hazy vision. You may develop a general haze in your vision or objects become blurrier. If you have a refractive error like myopia (nearsightedness) already, this development may seem like a progression of your existing eye condition, requiring new glasses or contact lenses. You may feel like you constantly have dirty glasses or contact lenses, and you can never get completely clear vision with visual aids. You may not even notice this change at first until the cataract progresses enough that you cannot see clearly even with corrective wear. You may feel like you are walking around in fog.
  • Spots of fuzziness in vision. You may feel like you cannot get your glasses or contact lenses clean, or you may not be able to blink the spot away like when you have a small foreign object in your eye. This could obscure your vision in ways that are hardly noticeable in the very early stages, maybe leading to a blind spot or difficulty seeing things when they are in certain areas of your vision.
  • Dimness requiring more light for tasks. If the cataract darkens the lens of the eye rather than clouding or obscuring it, you may start to need more light to perform tasks, especially at dawn, dusk, or night. When you are indoors, you may need a brighter screen on your electronics or a brighter light to read and write. As the cataract progresses, using more light will not help you see better, but in the early stages, turning up the brightness or turning on more lights may not seem like a problem.
  • Reduced intensity or yellowing of colors. Colors may seem dimmer or more yellow, like the world is turning into a sepia-tone photograph. This is not likely to be noticeable for a long time, especially if there are no other vision problems associated with it.
  • Increased sensitivity to light. If you find yourself squinting in sunlight, at overhead lights, or at the light coming from electronic devices, you may be developing cataracts. It is hard to know that this sensitivity is a cataract versus another eye condition, like glaucoma, because it is a symptom associated with several conditions. At first, this symptom may mean you wear sunglasses more often, which is actually good for your eyes; however, it may also mean you have more difficulty seeing at night, especially when driving, because headlights can be excessively bright.
  • Glares or halos around lights. This may be associated with overall fogging or fuzziness in your vision, or it may be a symptom on its own. Like many of the early stages of other listed symptoms, this one may feel like your contact lens are dirty or old, or you have smudges on your glasses that you cannot clean off. As it progresses, you may have other symptoms, including more difficulty seeing in general and serious difficulty seeing at night.
  • Change in your refractive error. Refractive errors are problems with the shape of your lens, leading to issues refracting light onto the retina. These include nearsightedness (myopia), farsightedness (hyperopia or, when caused by aging, presbyopia), and astigmatism. If you have these errors, they will progress over time, so you will need updates to your glasses and contact lenses consistently. However, if your vision starts getting worse very quickly, and you need a lot of adjustment to your corrective wear over one year, there may be an underlying cause, including a cataract. In some cases, your refractive error may get better temporarily before the cataract progresses. While this may seem like a sudden boon, your optometrist or ophthalmologist will want to know why this occurred. It may lead to them to diagnose an early stage cataract.
  • Double vision in one eye. Like other symptoms, this may not be noticeable in its early stages, especially if you are already farsighted and have trouble focusing on objects close to your face. While double vision in both eyes is a symptom of many eye conditions, if you close one eye and still see double or multiple images in one eye, you likely have a problem in the lens of your eye leading to serious issues refracting light, and your brain is processing a poorly transmitted image.

Cataract Treatment is Simple to Manage Over Time

The only way to diagnose a cataract is for an eye doctor to examine your eye, listen to your reported symptoms, and find the spot or discoloration in your lens. To diagnose a cataract, your eye doctor will dilate your pupil, so they can see the lens of your eye and then examine the area with a slit lamp and ophthalmoscope. Your doctor will also give you a visual acuity test, which usually involves reading a Snellen chart to determine how clearly you can see at what distance and how serious your refractive error is.

Once the cataract has been located, there is no way to stop the cataract from growing; however, you can make lifestyle changes to slow its progression in some cases.

  • Take medications to manage chronic illnesses associated with cataract development, like diabetes.
  • Quit smoking.
  • Moderate how much alcohol you drink or stop drinking altogether.
  • Get help ending other kinds of substance abuse.
  • Eat a healthy diet full of vitamins and minerals, and take vitamin supplements if necessary.
  • Get enough exercise to manage weight and blood sugar.
  • Wear ultraviolet-protecting sunglasses because UV radiation damages the lens of the eye.

Your eye doctor will monitor the progress of your cataracts. They will spot when the other eye begins to develop a cataract, because this condition will occur in both eyes, and provide updates to vision correction like glasses or contact lenses to manage refractive errors caused by the cataracts as long as possible. For many people, a new prescription for glasses, including those with an antiglare coating, can help for years as the cataract’s symptoms progress. You are most likely to require vision exams once a year, although if you are younger, have an underlying health condition contributing to cataracts, or have a rapidly developing cataract, you may be in your eye doctor’s office every six months.

Cataract Surgery

While prescription glasses can help patients with cataracts maintain their vision as symptoms progress, you will still need regular eye exams to assess the development of cataracts. Ultimately, cataracts may excessively dim or cloud your lens until you cannot see clearly enough to perform your daily tasks, even when using contact lenses and glasses.

In this instance, you will need cataract surgery to remove your clouded lens and replace it with a clear artificial one that can be either a monofocal, accommodating, or multifocal intraocular lens. The surgery is pretty straightforward and takes 30 to 45 minutes.

Your cataract surgery can be done within a few hours under local anesthesia so you can go home after the procedure. However, after the operation, the doctor might place an eye patch over the treated eye and observe you for signs of bleeding or infections.

When leaving the hospital, ensure you get someone to drive you home. You will also need glasses for tasks like reading, regardless of the type of intraocular lens you receive during surgery.

References

  1. Cataract. American Optometry Association (AOA).
  2. Facts About Cataracts. (September 2015). National Eye Institute (NEI).
  3. What Are Cataracts? (November 9, 2018). American Academy of Ophthalmology (AAO).
  4. Cataract. Prevent Blindness.
  5. Cataracts FAQ. Wilmer Eye Institute, Johns Hopkins University Medicine.
  6. Cataract surgery overview. (February 9, 2021). NHS.
  7. Cataract: What You Should Know. (September 2015). U.S. Department of Health and Human Services.
  8. Cataracts. (November 2014). University of Michigan.

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