Cataracts are progressive damage to the lens of the eye, leading to cloudy, dim, fuzzy, double, or yellowed vision that will eventually cause blindness if left untreated. (Learn More) While the prospect of dealing with cataracts may seem scary, the condition is well understood by optometrists and ophthalmologists, so regular eye exams can help your eye doctor spot a cataract in the early stages. Your doctor will then help you manage the condition until you need surgery, which may not be for many years. (Learn More)
There are several steps you can take before surgery to manage cataracts, depending on underlying conditions that may have led to the problem. Lifestyle changes to improve your health — eating healthier foods, taking vitamins, and exercising — can help, and these changes can improve symptoms from other chronic diseases. (Learn More) If you have an underlying health issue like diabetes, hypertension, or a condition requiring medications that increases your risk of cataracts, you should speak with your primary care provider about how the interaction of your chronic illness, medication, and lifestyle changes impact your risk of cataracts.
You should also speak with your optometrist and ophthalmologist about your underlying conditions, so they can monitor your vision for any changes indicating cataracts. (Learn More) Keep reading for more information on ways to prevent cataracts, depending on how serious your risk is.
What Can I Do to Prevent Cataracts?
A cataract is a progressive problem that develops in the lens of the eye. Damaged proteins clump together and form sports, cloudiness or haze, or darken the lens until, if left untreated, vision is obscured completely. While untreated cataracts do lead to blindness, diagnosing and treating cataracts is a common experience for optometrists and ophthalmologists in the United States. It is important to know that there are easy-to-manage approaches, including lifestyle changes and eventually surgery.
Common Causes of Cataracts and Lifestyle Changes You Can Make
Aside from malnutrition, there are several other causes of cataracts.
- Smoking: Quit smoking if you have been diagnosed with cataracts, and this can help slow the progression of the disease. If you are at risk of developing cataracts — due to being middle aged or older, or because of an underlying illness — quit smoking to reduce your risk of developing cataracts.
Although the relationship between cataract development and smoking is not well understood, there appears to be a link between the two conditions. One survey from 2011 reported that prevalence rates of age-related eye disorders like cataracts were higher among current smokers than former smokers: 48 percent compared to 41 percent, respectively. People who had smoked or were current smokers, and had developed a cataract, were also more likely to experience visual impairment compared to those who never smoked and developed a cataract; the only group for whom this did not hold true were those with either glaucoma or diabetic neuropathy.
- Drinking too much alcohol: The Centers for Disease Control and Prevention (CDC) offers guidelines on moderate drinking and notes that there is no such thing as completely safe drinking. If you have an underlying health problem or are just worried about developing cataracts, drinking less or quitting altogether can reduce your risk of cataracts along with several other physical ailments.
- Insufficient exercise: Regular exercise reduces the risk of developing or worsening several conditions, including heart disease, diabetes, weight-related problems, and lung problems. Some chronic diseases like diabetes and hypertension are associated with developing cataracts, so making this lifestyle change can manage symptoms of your underlying chronic illness, which will in turn reduce the risk from associated problems like cataracts.
The CDC recommends that adults get at least 2.5 hours per week of moderate-intensity exercise or 75 minutes of vigorous aerobic activity. Aerobic activity should be performed in 10-minute intervals, at least. This should all be spread throughout the week. It is important to increase your exercise routine progressively as your body changes and becomes used to the current amount of exercise you get.
- Some drugs: If you can, lower your dose or quit taking steroids, especially corticosteroids. You may have a condition that requires taking these regularly, but they do increase your risk of developing cataracts, so speak with your medical provider about the risk.
Chlorpromazine, an antipsychotic medication, also increases the risk of developing cataracts. If you are concerned about this as a long-term side effect, speak with your doctor about the risks, what you can do to manage them, changing the dose to reduce risk, or even switching medications if that works for you.
Estrogen replacement therapy has been linked to an increased risk of cataracts. Women who experience severe perimenopausal or menopausal symptoms often receive hormone replacement therapy (HRT) to reduce their risk of other problems, but this approach to treatment has its own series of side effects, including a higher risk of developing cataracts.
Never quit taking a prescribed medication without consulting your doctor. You have received this prescription for a reason. Unless it is a drug that you take as needed, or that you are supposed to stop taking after one round (like opioid painkillers or antibiotics), you should always consult your medical provider to understand how the drug will impact you and what you can do to manage side effects like cataracts.
- Ultraviolet radiation: UV radiation has been tied to damage of all kinds of organs, including the skin and eyes. Wearing protective sunglasses with a UV-reducing coating will protect the lens of your eyes from this kind of damage, so you can slow how damaged the proteins in this organ get over time.
Diseases Associated With Higher Cataract Risk
There are some diseases that are associated with an increased risk of developing cataracts. While many of these chronic conditions can benefit from the lifestyle changes above, they may also involve regular physician checkups and some medications to manage.
- Diabetes mellitus: This disease affecting the blood sugar is associated with an increased risk of cataracts. The lens of the eye gets nutrition from the aqueous humor, or the fluid that fills the eye and provides oxygen and glucose (processed sugar from food you ingest) to the organs in the eye.
If you do not have control over your blood glucose levels due to untreated or undiagnosed diabetes, the blood sugar in your eye will also rise, and this can damage different parts of the eye, including the proteins in the lens. The lens may swell because of too much glucose, and this will affect your vision’s clarity. The lens contains a substance that converts glucose to sorbitol, a different type of sugar. When sorbitol collects in the lens, it can change the proteins in the lens, leading to fogging or clumping, the early stages of cataracts.
If you receive a diagnosis of diabetes mellitus, work with your doctor to manage your blood sugar. This will involve a combination of lifestyle changes and medication, which will adjust over time as your diabetes symptoms change or progress.
- Hypertension: Chronic high blood pressure, called hypertension, is associated with an increased risk of developing cataracts. According to a 2014 survey of metadata, posterior subcapsular cataracts (PCSs) were the most likely to develop.
A PSC is a rapidly growing cataract that occurs more often in younger people than middle-aged and older adults, so it requires more frequent monitoring. To reduce your risk of this type of cataract, manage your weight with diet and exercise, get regular treatment from medical professionals to understand your blood pressure, and take prescription drugs as recommended by your doctor. If you have any concerns about the association between cataracts and hypertension, and how any hypertension treatments may impact this risk, speak with both your doctor and your optometrist. If your eye doctor knows your overall health and your concerns about your health, they will be better able to help you monitor symptoms of this disease and slow the progression if cataracts do develop.
- Congenital cataracts: Diseases contracted during fetal development in utero lead to clouding of the lens of the eye before birth. Some congenital cataracts are genetic, like those associated with Down syndrome or family history. Others, like those caused by rubella, can be prevented. Pregnant women, or women who wish to become pregnant, should speak with their doctor about how to prevent diseases in utero and if they may need genetic screening for conditions that would impact their child’s risk of congenital cataracts.
- Eye inflammation or disease: When the lens of the eye experiences trauma from an illness or inflammation, you may damage the proteins in the lens and that can lead to cataracts many years later.
- High myopia: Extremely high nearsightedness, or myopia, is associated with a higher risk of cataract development, along with other eye problems like retinal detachment and glaucoma. It is not a well-understood correlation, but it seems that high myopia diagnosed before age 20 is associated with changes in the shape of the eye, which may damage the lens of the eye and lead to cataracts later in life.
Unfortunately, this problem is also linked to higher risks with cataract surgery, but the best way to prevent cataract development or slow its progress is to go to regular eye appointments and monitor the progress of your overall eye health.
Diagnosis and Treatment of Cataracts
Ultimately, if you are at higher risk of developing cataracts, there are not many ways to stop the progression of this disease. Once you do have a cataract, you will likely get a cataract in the other eye eventually.
Your optometrist or ophthalmologist will be able to monitor the progress of this disease over time and to improve your vision with higher prescriptions for glasses or contact lenses until this no longer makes a difference in your visual impairment. This is likely to take years to occur. For example, age-related cataracts are likely to first appear in people 40 and older, but most of these individuals will not need surgery until they are in their 60s.
Additionally, cataract surgery is a well-understood procedure. Nine out of 10 people who undergo cataract surgery and receive an artificial lens to replace the damaged biological lens report visual acuity improved to 20/40 or greater. With the help of an experienced ophthalmologist, you can maintain your vision for as long as possible and be recommended for surgery when it becomes necessary for your life.
Lifestyle choices and appropriate medical diagnoses are great ways to prevent or slow the progression of cataracts. If you are worried about developing this condition or have already been diagnosed with a small cataract, speak with your optometrist about preventative measures and the latest information on modern cataract treatments.
Facts About Cataracts. (September 2015). National Eye Institute (NEI).
Smoking and Visual Impairment Among Older Adults With Age-Related Eye Diseases. (July 2011). Preventing Chronic Disease: Public Health Research, Practice and Policy. Centers for Disease Control and Prevention (CDC).
Fact Sheets – Alcohol Use and Your Health. (January 3, 2018). Centers for Disease Control and Prevention (CDC).
Physical Activity Guidelines. (July 16, 2018). Centers for Disease Control and Prevention (CDC).
Chlorpromazine. (July 15, 2017). Medline Plus.
Estrogen Replacement Linked to Cataract Risk. (March 3, 2010). MedPage Today.
The Known Health Effects of UV. World Health Organization (WHO).
Cataracts: Overview. (June 23, 2018). Mayo Clinic.
Diabetes and Cataracts. (November 10, 2013). American Academy of Ophthalmology (AAO).
Hypertension and Risk of Cataract: A Meta-Analysis. (December 4, 2014). PLoS One.
Congenital Cataract. (August 15, 2017). Medline Plus.
Another Problem With High Myopia: Cataract. End Myopia.org.