Cataracts – what are they and do I have to do something about them?

I often get asked this question in one form or another; cataract is one of the commonest conditions occurring in about 30-40% of the population in the developed world aged 70 and over. Cataracts come in a variety of shapes and forms but all are a result of changes in the transparency of the eyes own natural lens (crystalline lens) which develops opaque areas with aging. The effect this has on your vision greatly depends on the shape and size of the opacities within the lens. The changes in the lens start as early as aged 40 but generally only start to form large enough areas to disrupt vision later in life.

There are other types of non age-related cataract which occur in isolation or are secondary to some other eye conditions and you can find information on these in the links below however we will mainly discuss age related cataract here.

So what are the causes of age-related cataract? The clue is very much in the name i.e. mainly aging however there are some risk factors which may cause earlier onset of cataract or make cataract worse, for example smoking, previous exposure to UV light (the prevalence of cataract is higher in more tropical regions), poor diet, diabetes, family history of cataract etc. Some of these such as smoking (another of the many reasons to give up if you have not already) and diet can be influenced and wearing sunglasses to protect against exposure to UV is important, however others such as family history can not.

What are the treatment options for cataract? Cataract is treated by removal i.e. removing the crystalline lens and replacement with an artificial one. Cataract surgery is the most common surgical treatment for the eye. Complications are quite rare and the procedure takes as little as 20 minutes and normally as a day case so you can go home afterwards.

Do I have to have treatment? – No, if you are happy with your vision and your level of vision is sufficient for your needs e.g. if you drive you can meet the necessary standards, then you do not have to have any treatment. Cataracts generally mature very slowly and may never develop to a stage where they cause severe sight loss or further complications.

How can I get treatment if I want to? – The first step is to have an eye test where we can assess your cataracts and what impact they are having on your vision and lifestyle. As part of this we will discuss with you the surgery the benefits and possible complications and if you wish to be referred we can do this either privately or through the NHS.

Some myths:

Cataracts can be treated with laser – unfortunately not, this myth may have resulted from a common post surgical treatment following cataract removal but lasers cannot be used to remove the cataract initially.

Can cataracts come back – No as the cataract is an opacity in the eyes natural crystalline lens once this is removed a cataract cannot reform.

Do cataracts have to be a certain size before they can be treated “do they have to be ripe” – no you can have cataract surgery any time, though there may be restrictions imposed locally by NHS commissioners for financial reasons on who can and cannot have surgery.

The links below provide further information on cataracts and treatment including an excellent detailed article and interview with a cataract patient by the RNIB.

Bibliography

Cataracts Information. (n.d.). Retrieved from RNIB: http://www.rnib.org.uk/eye-health-eye-conditions/cataracts-information-0

NHS Choices – Age-related cataracts . (n.d.). Retrieved from NHS Choices: http://www.nhs.uk/Conditions/Cataracts-age-related/Pages/Introduction.aspx

 

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