Most often, cataracts require surgery to remove them, but some people never need cataract surgery.
If left untreated, your eye doctor will monitor your cataracts regularly, keeping an eye on the rate of progression. If things reach a certain point, surgery will be recommended.
Cataract surgery can be accomplished through laser-assisted technology that removes the cloudy lens and replaces it with an artificial clear one. Cataract surgery is considered safe, and it is a common treatment for improving vision related to cataracts.
While a small number of people may never need cataract surgery, most people with cataracts will eventually need to have them removed via surgery.
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Progression of Cataracts
Cataracts can be unpredictable, and they can progress at variable rates. In general, if a cataract is age-based though, meaning that the clouding of lens is purely due to age and not because of an injury or illness, the cataract is liable to progress rather slowly. This can give you time to decide on the right course of treatment and determine if and when surgery is the best course of action.
Cataracts are often a natural part of aging, as the proteins bind together and cause cloudiness on the lens that impairs vision.
The National Eye Institute publishes that age-related cataracts can form in a person's 40s or 50s, but they generally progress slowly enough that they do not start to really impair vision until age 60 or so. The proteins may start clumping together to form a small cataract around middle age; however, the cataract doesn't get big enough to cause vision problems for several more years.
Cataracts that are related to injury or illness or that occur in a younger age can progress more quickly than age-related cataracts. The following can increase the risk for cataracts and be a contributing factor to their onset:
- Illness such as diabetes
- Use of some medications like corticosteroids
- Injury to the eye
- Surgery on the eye
- Radiation treatments, especially on the upper body
- Family members who suffer from cataracts
- Poor nutrition and obesity
- Excessive alcohol consumption
- Extended and unprotected exposure to ultraviolet sunlight
Symptoms of Cataracts
The main symptom of a cataract is blurry vision. Other symptoms include:
- Trouble seeing in low lighting
- Halos around lights
- Declining vision
- Sensitivity to light
- Eye strain
Types of Cataracts
There are multiple forms of cataract. Age-related cataracts form slowly and progress over several years, while a secondary cataract can occur as the result of other health problems or illnesses and progress more quickly.
Traumatic cataracts occur as the result of an injury to the eye and may form several years after the incident. Radiation cataracts form after exposure to radiation.
Congenital cataracts are present from birth and typically manifest in childhood. These cataracts may be small and do not impact vision, although they can be larger and require surgery to remove them to preserve vision.
Cataracts can form on different parts of the lens as well. For example, nuclear cataracts impact the center of the lens and often lead to discoloration, which can then interfere with reading and lead to nearsightedness.
These cataracts often form slowly as the lens of the eye darkens to a brown or yellowish-brown shade that can tint vision, making it difficult to correctly discern colors or even to read clearly. Cortical cataracts start at the outer edge of the eye's lens, and the whitish streaks slowly progress into the center of the lens to impair vision.
A posterior subcapsular cataract starts in the back of the lens, often directly in the path of the light, which then impairs night vision, vision in bright lights, and reading. It can also create halos or glares around lights. This form of cataract can progress much faster than the other types, Mayo Clinic explains.
Cataracts often require surgery to replace the lens in order to restore vision.
Dangers of Untreated Cataracts
Left untreated, cataracts can lead to vision impairment, vision loss, and even blindness.
In fact, the World Health Organization (WHO) reports that cataracts are the number one cause of blindness in the world. The Centers for Disease Control and Prevention (CDC) publishes that in the United States, cataracts are the biggest culprit for vision loss.
Cataracts often progress very slowly as the proteins clump together; however, if there is trauma, illness, if the eye (and body) is not properly cared for, or if the eye is exposed to sunlight, smoking, radiation, or certain medications, cataracts can form faster and require quicker intervention.
Cataracts can form in one eye or both, and they can progress differently in each as well. One eye may be worse than the other or progress faster, for instance.
Without treatment, cataracts can get large enough to impair vision completely. They can lead to vision loss and total blindness in some cases.
The Ease of Cataract Surgery
An intraocular lens (IOL) is used to replace the lens of the eye. The artificial lens implant generally improves and restores vision.
In 2021 and beyond, cataract surgery is considered very safe and effective. Your ophthalmologist can help you to determine if cataract surgery is right for you.
Eye Health Statistics. (2015). American Academy of Ophthalmology.
What Are Cataracts? (September 2021). American Academy of Ophthalmology.
Facts About Cataracts. (August 2019). National Eye Institute.
Cataracts. (June 2018). Mayo Clinic.
Priority Eye Diseases. World Health Organization.
Common Eye Disorders. (June 2020). Centers for Disease Control and Prevention.
Cataract Surgery. (March 2018). Mayo Clinic.