Cataracts: Your Complete Guide to Vision Loss and Prevention

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More than 2.5 million Canadians are currently living with cataracts. One of the eye conditions often associated with aging populations, a cataract can cause significant visual changes and in some extreme cases, total vision loss. It’s the second leading cause of blindness in the world.

Cataracts develop and worsen over time. The lens of the eye, which is naturally clear, starts to harden and yellow, causing visual clouding. As the condition progresses, the clouding of the eye obstructs the retina, making it harder for light to reach it. This is why most patients don’t notice visual disturbances until it becomes much more difficult to see.

Types of Cataracts

1. Nuclear cataracts are the most commonly occurring type and most often age-related. This type of cataracts takes years to form, so the onset is often gradual and harder to detect.

2. Cortical cataracts develop outside the edge of the lens, inside its cortex. The cortex is composed of water and proteins. Changes in the water and proteins can cause fissures, scattering light as it enters and resulting in blurred vision. This type of cataract often occurs in patients with diabetes.

3. Posterior subcapsular cataracts start as a small, cloudy areas in the back of the lens surface, forming beneath the lens capsule. This type of cataract most often develops in individuals with diabetes, extreme nearsightedness, or retinitis pigmentosa. It can progress very rapidly (within months).

Cataract Symptoms and Risk Factors

The prevalent perception of cataracts is far grimmer than the condition and its treatment. It’s important to note that the more devastating effects arise if the cataracts are left untreated. The good news is that cataracts are completely treatable; in fact, more than 350,000 cataract surgeries are performed in Canada every year. The procedure has come a long way since it was first documented in the fifth century BC, which is why most patients are ready to go back to work within a few days. While complications can occur, they are quite rare and easily treated. But the innovation doesn’t stop there: new findings suggest that a non-invasive alternative, drug therapy, may be a possibility in the future.

Before we cover the current treatment options, it’s important to recognize the symptoms of cataracts, know the factors that can increase the risk of developing them, and understand how they can be prevented.

The symptoms of cataracts often vary among individuals. No two individuals are alike, so the symptoms may present differently in each person and in varying intensities. For instance, vision changes often start slow and can be hard to detect without regular eye exams or visits to the doctor. In many cases, individuals are unaware of vision loss.

Typically in adults, the signs and symptoms of a cataract include:

• dimming vision (can appear clouded)
• yellowing or fading of colours
• loss of night vision or increased difficulty in low light situations
• light sensitivity and issues with glare from screens and light sources
• halos around lights
• frequent prescription changes
• double vision in a single eye
• any yellowish or brown discolouration on the lens
• issues with depth perception
• development of nearsightedness
• pain sensations during bright days

While most cataracts are age-related one of the biggest misconceptions is that they only presents in older populations. Contrary to popular belief, cataracts can affect anyone at any age. There are congenital cataracts, meaning that babies can be born with cataracts or be predisposed to them. Although they are rare, children can also develop pediatric cataracts, which is why it’s so important to monitor how a child is interacting with its surroundings, whether the child is voicing any kind of discomfort how their eyes look.

Some symptoms of cataracts to watch for in a child:

• a pupil that looks light when it’s flashed with a light
• misaligned eyes
• uncontrollable eye movements that are rhythmic (nystagmus)
• signs of blurry vision or trouble seeing
• sensitivity to bright lights or glares
• seeing a halo, or circles around objects

Risk Factors
In other cases, cataracts can be brought on by illnesses such as diabetes, arthritis, or glaucoma, triggered by an eye injury or exposure to some forms of radiation. The complete list of risk factors include:
• Diabetes
• Exposure to sun and UV rays
• Smoking
• Obesity
• High blood pressure
• Past eye injuries/inflammation or ocular trauma
• Eye surgery
• Steroid medication use
• Aging
• Your eye colour
• Family history of cataracts

Preventing Cataracts

Until we figure out how to turn back the hands of time, we have lifestyle adjustments in our corner. Prevention starts with understanding the risk factors and managing the primary triggers of cataracts, which include obesity, smoking, diabetes, high blood pressure, and steroid medications. Remember that untreated eye injuries and conditions can also lead to the formation and progression of cataracts. It’s important not to minimize the impact and importance of regular eye checkups and the guidance of your doctor.

The following is an introductory guide to mitigating risk factors and improving the overall health of the eyes.

1. Diabetes
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The National Institute of Diabetes and Digestive and Kidney Diseases warns about the secondary diseases people can develop when they’re diabetic. Cataracts fall under the group of four serious eye problems — diabetic eye disease. The other three include diabetic retinopathy, diabetic macular edema and glaucoma.
Diabetes is one of the key factors in cataract development. Many pre-diabetic patients are not aware that they carry a higher risk. Research suggests that by lowering their HbA1c levels by just 1%, type 2 diabetics can reduce their risk by 19%. Diabetic patients need to have their blood glucose levels stabilized before they’re greenlit for cataract surgery.

2. UV Radiation
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While sunglasses look cool, they do serve a purpose: protecting your eyes! Years of direct sunlight exposure can take a toll on your eye health. The National Eye Institute has confirmed that there is a proven link between UV rays and oxidative stress, causing the lens proteins to undergo advanced glycation, which makes the lens less transparent. As we learned earlier, when the lens becomes less transparent, it becomes harder for light to travel within the eye, and ultimately harder to see. Prolonged and unprotected UV exposure can affect the composition and structure of the eye, which leads to conditions like elevated tissue on the eye surface, macular degeneration and cataracts. A way to minimize your UV exposure is to wear sunglasses.
You can learn more about how UV rays affect your eyes and which lenses can best protect them and suit your needs.

3. Your Eye Colour

Your eye colour may make you more at risk for developing cataracts. Research suggests that those with brown or hazel eye colours are 2.5 times more likely to develop the disease than their light-eyed counterparts. Darker eyers have a higher quantity of melanin, the pigment that adds colour to the skin, eyes and hair, and draws in UV light. If your eyes are darker and absorb more light, this can heat up and damage the lens.
Remember that regardless of eye colour, the sun is still very damaging. In other instances, glycation (lens protein damage) is what typically triggers cataracts. UV light can trigger oxidative reactions in the eye cells, leading to cloudiness. It’s important to reiterate that UV-coated sunglasses and less time in the sun are your best bets against harmful UV damage.

4. Diet
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While research has not yet established a solid link between proper nutrition and cataract prevention, there is ample evidence that a balanced diet can help. A good approach is by introducing foods that are rich in antioxidants and B vitamins. You’ll also want to manage your intake of low-quality carbs (refined, white starches, sugary foods and beverages).

5. Eye Exams
There are common misconceptions about how often we should be scheduling eye appointments. It’s easy to forget to take care of your eyes when there doesn’t seem to be any impending issues. Ideally, people should come in every two years, but it’s especially recommended that patients between the ages of 40 and 64 prioritize eye exams in their health plans. Adults over 64 should make annual appointments. While this guide is meant to take some of the guesswork out of cataracts, it can still be very difficult to assess your symptoms on your own. The best way to address your concerns is by talking to your eye doctor. An eye exam is a great starting point: it assesses the overall health of your eyes and provides a necessary baseline for tracking the progression of an ocular condition.
If you are noticing any changes to your vision or new sensitivities, we recommend booking a comprehensive eye exam immediately. Visit us at your local FYidoctors clinic.

Treating Cataracts

A temporary measure would be the use of a magnifying glass which is a convex lens to help enlarge appearance of objects to making them easier to see. This section explains the available treatment options for cataracts.

People often ask doctors if cataracts can be permanently fixed. The answer is both yes and no. If you have symptoms, they cannot be reversed naturally without surgery. However, a procedure can completely get rid of cataracts. The best thing to do is to assess risk factors, prevent them, and have an eye exam to catch them early. Cataracts are easily treated because they get worse slowly and can be caught before they make you lose all your vision. Usually, a doctor will suggest lens correction surgery. Many people ask doctors if cataracts can be permanently fixed. The answer is both yes and no. If you have symptoms, they cannot be reversed naturally without surgery. However, a procedure can completely get rid of cataracts. The best thing to do is to assess risk factors, prevent them, and have an eye exam to catch them early. Cataracts are easily treated because they get worse slowly and can be caught before they make you lose all your vision. Usually, a doctor will suggest lens correction surgery. Cataract surgery is not as difficult as it used to be. Thanks to new technologies, it is simple, fast, and you recover quickly.

Lens Correction Surgery

Remember that a cataract affects the lens of the eye, so in order to remove the cataract, you need to replace the lens of the eye. Lens correction treatment consists of replacing the existing lens with an artificial lens. During surgery, the natural lens is broken up with ultrasound waves. The small pieces are gently vacuumed out. The new lens, made of silicone or acrylic, is then inserted. Artificial lenses work like prescription contact lenses: they are made with a prescription to help you see better.

Laser-Assisted Surgery

Laser surgery is a new way to treat cataracts. A computer maps your eye's surface, helping the surgeon aim the laser correctly. The laser then makes cuts in the exact spots that were mapped. It can also help soften cataracts before they are removed with an ultrasound probe. This surgery is best for people with astigmatism.

Postoperative Care

The expected recovery time is the same for both types of cataract surgeries. Most people can see clearly almost immediately, while others experience a gradual improvement in a week or two. You can expect full pain-free recovery within three months. Your eye may feel itchy or watery, so your doctor may prescribe eye drops to help.

Innovation and Technology

Like anything, the best results for cataract treatment come with early detection. But a common struggle with diagnosis is how slow and subtle the changes can be. Thanks to advances in technology, tools such as the HD analyzer can detect cataract formation so early that eyesight may not be affected. The HD analyzer uses lasers to measure how the light scatters in the retina. The delicate readings can detect microscopic changes, prompting early treatment of the disease in younger patients. Looking to discuss more with a doctor, or feeling symptoms? Book an appointment at an FYidoctors clinic today!