Cataract

What Are Cataracts?

A cataract is what happens when the transparent lens you were born with starts to coagulate and turn cloudy. Your lens sits right behind your pupil and its role is to bend the light to reach your retina so that you can see clearly. For your lens to do its job properly it has to be transparent otherwise the light won't reach your retina and you won't be able to see that well, if at all.

When you have a cataract, your eye's lens becomes too stiff, starts to coagulate and become cloudy. It's like the way an egg white starts off transparent but as you cook it, it becomes milky white. This is called oxidative stress or protein denaturalisation – which is a bit like you’re looking through a dirty car windscreen that you can’t quite wipe clean.

If your world is starting to look a bit cloudy, or you are increasingly more glare sensitive, it is important to have a comprehensive eye examination with an optometrist. If cataract is detected, your optometrist may refer you to an ophthalmologist, a medical doctor specialising in the eyes and eye surgery, for further examination and treatment.

Types of Cataract

There are three main types of cataract:

• Nuclear Sclerotic Cataract – this is virtually an ‘age-related’ optical disease that is caused primarily by gradual hardening and yellowing of the lens nucleus.
• Subcapsular Cataract – this occurs at the back of the lens and is mainly prevalent in diabetic individuals and those who intake high dosage of steroidal medications.
• Cortical Cataract – this occurs when white, wedge-like opacities develop in the lens cortex, working their way to the centre in a spoke-like fashion.

If you believe you have cataracts, or experiencing the signs of cataracts, make an appointment to see your optometrist immediately for a comprehensive eye examination. If you don’t have an optometrist, use our search function to find one close to where you live or work.

Symptoms of Cataracts

Your vision is cloudy or blurry. Colours fade away. When you’re driving, car headlights bother you more than usual, and you’re beginning to avoid driving at night.

If you wear prescription glasses, it might seem like your glasses lens is scratched or dirty, but it isn’t really. There is likely to be nothing wrong with your glasses but your own eye’s cloudy lens – your cataract that is – which is causing this feeling.

We recommend visiting an optometrist for an eye examination if you are experiencing any difficulties with your vision. If you don’t have a regular optometrist, you can find an optometrist near you by using our Find an optometrist search function and/or use the form located on the top of each page of goodvisionforlife.com.au.

Who Gets Cataracts?

In Australia over 700,000 people are living with cataracts with cataract surgery the most commonly performed eye procedure natinally.

Statistics indicate that over a 10-year period in those aged 49 and over, the risk of developing nuclear cataracts is 36% and 28% for cortical cataracts. In Australia, of those who do develop cataracts the average age for cataract surgery is 75.8 years. The frequency of cataracts occurring in younger people within Australia is less occurring in 1 in 4,500 infants or children.

Some people will be more prone to cataract than others:

• Age-related cataract – this is the most common case of cataract with prevalence in individuals aged 40 and over.
• Congenital cataract – some babies are born with cataract – but fortunately, many but not all cases, require paediatric cataract surgery.
• Secondary cataract – this form of cataract is primarily caused by diseases linked with glaucoma and diabetes, or the use of steroid medication.
• Traumatic cataract – this develops after an injury to the eye, but it can take several years to make itself obvious.
• Radiation cataract – this can form after a person undergoes radiation treatment for disease like cancer.

You can see more information about cataract here in this infographic.

Photo Credit: Unsplash, BBH Singapore

Cataract Surgery

Is there a ‘right’ time to have surgery?

Forty years ago, people would wait until their cataract was mature before it could be removed. That was because the technology to dissolve the cataract was only widely introduced in the 1990s. These advances mean that you can now have cataracts treated much earlier, especially when they interfere with daily activities such as your ability to drive or read.

If you think you have cataracts or are interested in having cataract surgery, visit your optometrist for a thorough eye examination. Your optometrist will examine and discuss your cataracts with you and then refer you to an eye surgeon if needed.

For more information on what cataract surgery entails, read our article, Demystifying cataract surgery.

ach year, 250 000 Australians have cataract surgery, making it the most frequently performed elective operation in Australia. Credit: Sydney Eye Hospital Foundation

Case Study - Joan's Story

In 2015, our parent organisation Optometry Australia published a terrific story on a cataract patient, Joan Brennan. We publish below, an extract from this article as it is a great insight into cataract surgery and a patient’s recovery.

“In 2015, Joan Brennan, then 83, took part in a clinical trial of a new lens for cataract patients who also had age-related macular degeneration, conducted by ophthalmologist Dr Chandra Bala.

Joan had advanced AMD and cataracts in both eyes. Dr Bala successfully implanted the lenses in both eyes.

After her surgery, Dr Bala said Joan had enjoyed significant improvements to both eyes with remarkable near vision improvement and had experienced no side-effects, glare, halo or distance vision problems.

Her vision improved to the point where she can read most print and she developed a sporting injury playing bowls as she can now see the jack.

‘Previously Joan couldn’t see the elevator buttons to leave my office,’ Dr Bala said. ‘She has had a marked improvement, with additional help from reading glasses. This lens has reduced the low vision aid power and she no longer carries a hand-held magnifier.’

Dr Bala is also a clinical senior lecturer at Macquarie University and adjunct senior lecturer at the University of New South Wales.”

Dr Chandra Bala (left) and his patient Joan Brennan (right)

 

Where Do I Go For More Advice?

We recommend making an appointment with an optometrist for a comprehensive eye examination. Comprehensive eye examinations, at regular intervals starting from childhood, ensure that most eye conditions can be prevented or corrected. Eye examinations can also be an important tool for determining your overall health.

Use our Find an optometrist search function if you do not have an optometrist, or would like to find an optometrist close to where you live.

Commonly Asked Cataract Questions

When is my cataract ‘ripe’ enough for surgery?

This is a common myth. The decision to have your cataract removed is based on how much a cataract is interfering with vision, and not on waiting until a cataract gets worse.

Are cataracts removed with lasers?

Yes. You now have the choice to have your cataracts removed using the latest laser technology, known as Laser-assisted Cataract Surgery.

Do cataracts grow back?

No. However, rarely, a different secondary ‘cataract’ on your intraocular lens (IOL) may develop following surgery. The good news is this can be fixed easily by your eye surgeon with a painless and quick procedure.

Who gets cataracts?

While most cataracts are found in people over the age of 50 years, cataracts can occur in those younger than 50.

How does an optometrist diagnose cataracts?

As part of your eye examination, your optometrist will check the health of your eyes. This includes using a special microscope to look at the lens inside your eye for any sign of cataract formation. Using these results and information from other tests, optometrists are able to tell if you have cataracts.

Can cataracts be treated?

Many people with small cataracts that are not advancing can be helped with new prescription glasses and a regular eye health examination.

When cataracts begin to affect your vision, interfering with your ability to work or drive, your optometrist will talk to you about the benefits of referring you to an ophthalmologist, or eye surgeon, to consider surgery to remove the cataracts. This operation is generally uncomplicated and has a very high success rate although, like all surgery, complications can occur.

How will I know when I need to have cataracts removed?

Because cataracts often progress slowly, you may not know you have a cataract or whether your cataract is making your vision worse. The best way to monitor your cataract is with a regular eye examination with your optometrist who will help you to maximise your vision, make sure your vision is safe for driving and talk to you about the right time for surgery to have the cataract removed.

Will cataract surgery hurt?

You should speak to your optometrist or eye surgeon about cataract surgery, its risks and recovery. Cataract surgery is usually performed under local anaesthetic and most people do not experience any pain during surgery. Most people describe the sensation of mild pressure around the eyes during surgery.

Published date: 01 September 2016 Reviewed date: 28 January 2020

Author: Luke Arundel, BAppSci (OPtom) Hons, FIACLE, FCCLSA, FBLSA, FBCLS, AdjAssProf University of Missouri St Louis, GCOT, CASA CO

Bio: Luke Arundel is Chief Clinical Officer of Optometry Australia. He graduated with Honours in Optometry from Queensland University of Technology in 1998 and has worked extensively in Australia and Ireland. He currently holds fellowships with the BCLA, CCLSA and IACLE and became an Adj.Ass Prof. of the University of Missouri, St Louis, USA in 2008.  His professional interests include keratoconus, post-graft and scleral lens fitting, dry eye, ortho-k and paediatric contact lenses. He has worked in specialty contact lens practices in Brisbane and Melbourne and in the contact lens manufacturing field along with time in the public health and education sectors. Luke’s role at Optometry Australia sees him provide professional services assistance to members in audits, investigations and medico-legal matters along with leading development of resources and special projects.

LinkedIn profile.

Disclaimer: No information provided on the Good vision for life website is intended to constitute or substitute advice from visiting an optometrist. Many factors unknown to us may affect the applicability of any information on this website. You should seek appropriate personalised advice from a qualified optometrist about any eye health and vision conditions.

References:

1. NCBI. January 26, 2017. Presbyopia: Overview. [ONLINE] Available at: https://www.ncbi.nlm.nih.gov/books/NBK423833/. [Accessed 28 January 2020].

2. AIHW. August 30, 2019. How common is visual impairment? [ONLINE] Available at: https://www.aihw.gov.au/reports/eye-health/eye-health/contents/how-common-is-visual-impairment. [Accessed 28 January 2020].