Cataracts is a condition that is common among the aging population. Research shows that by the time they are 80, approximately half of all Americans will either have cataracts or cataract removal surgery. Because of this, it’s important to know the signs of cataracts and have them treated before it becomes a problem.
Many people turn to cataract removal to help restore their vision. Although most cataract surgery recovery takes place without any problem, there are some instances where it does not. This article discusses eye cataract symptoms, treatment options, and post cataract surgery care. We’ll also cover what causes cataracts, how to prevent them from occurring in the first place, and the 19 warning signs and symptoms of cataract surgery complications.
Table of Contents
- Understanding the Pathophysiology of Cataracts
- What Causes Cataracts In Your Eyes?
- Cataract Symptoms In Humans: What Are The Symptoms Of Cataracts?
- How Do Doctors Make A Cataract Diagnosis?
- What Do Cataracts Look Like?
- Types of Cataracts
- Can Cataracts Cause Blindness?
- Can Cataracts Be Cured?
- Cataract Treatment Options
- What is Cataract Surgery?
- When To Have Cataract Surgery
- How Much is Cataract Surgery?
- How Is Cataract Surgery Done and What Are The Types of Cataract Surgery?
- What Does Cataract Surgery Aftercare Entail?
- 19 Cataract Surgery Side Effects
- How To Prevent Cataracts
1. Understanding the Pathophysiology of Cataracts
As we mentioned above, cataracts in humans are relatively common. By definition, a cataract occurs when there is clouding in the lens of the eye and affects vision. You can develop a cataract in one or both eyes. The condition is not contagious, and it will not spread from one eye to another.
Your lens is the part of the eye that helps you see the light or an image on your retina. The retina is located in the back of the eye and is made up of tissue that is light-sensitive. In a healthy eye, a light will pass through your lens to your retina. Once it reaches this area, your retina changes the light into nerve signals and sends them to your brain where you process information. For this process to occur, your lens must be clear. If it is not, then the image that you see in front of you will appear blurry.
There are two primary ways in which cataracts can affect your vision. First, clumps of protein accumulate in your eye and reduce the ability of the retina to see sharp images. Because the lens is made of mostly protein and water, it is easy for protein to collect in this area. When it does, it causes the lens to become cloudy and reduces the amount of light that reaches your retina. This clouding could become severe enough to result in blurry vision. Research shows that most age-related cataracts occur as a result of protein clumping.
If the cataract is small enough, your eye might only be cloudy in one area and no changes to your vision will occur. However, cataracts tend to grow over time, which means that the cloudiness can get worse and this can affect your vision by making your images appear blurry or dull.
The second way cataracts can affect your vision is by causing your clear lens to turn yellow or brown. By adding a brown tint to your vision, you may not be able to see as clearly. Clear lenses slowly become brown or tinted with age. Early stages of cataracts may occur when the tinting in your lens makes it more difficult to see or read. This gradual change in tinting of your eye lens might not affect the sharpness of your vision, but advanced discoloration could cause you to lose the ability to see certain colors, such as purple and blue. You might have a hard time identifying the color of your clothing or other images around you.
2. What Causes Cataracts In Your Eyes?
Many people want to know, “How do you get cataracts?” Cataracts tend to occur naturally with aging, but this is not always the case. Some people may develop cataracts as early as their 40’s or 50’s. However, most people who have age-related cataracts do not seek treatment until after age 60.
To understand what causes cataracts, it helps to know how the lens works. As we mentioned before, your lens is located in the back of the eye behind the pupil and iris. It operates similarly to a camera lens by focusing light onto your retina so that an image can be sent to your brain and recorded. Your lens is also responsible for adjusting your eye’s focus. This means that it allows you to see things that are both near and far away. The protein that is located in your lens helps keep it clean to let light pass through so that it can reach your retina.
(Image source: https://www.eyehealthweb.com/cataracts/)
However, during the natural aging process, these proteins may clump together and cause an area of your lens to become cloudy. This is how a cataract forms. The cataract may then grow bigger over time so that your entire field of vision becomes blurry and it becomes harder to see. Research shows that other aspects may also contribute to cataracts, such as diabetes and smoking. Other factors that put you at risk for cataracts are certain diseases, drinking alcohol, and overexposure to ultraviolet sunlight. But in most cases, the natural process of aging causes wear and tear on your eyes that give way to cataracts.
3. Cataract Symptoms In Humans: What Are The Symptoms Of Cataracts?
Signs and symptoms of cataracts may vary from person to person. Early cataract symptoms might be hard to catch. This is why you’ll want to make regular appointments with your eye doctor.
The most common symptom of cataracts is blurry vision. Other people such as your doctor might be able to see your lens become cloudy.
Here are some other common symptoms of cataracts:
- The inability to see certain colors
- Dull vision or losing your sense of sharpness
- The inability to read
- The inability see objects clearly both near and far
- Colors appear less vibrant
- Seeing a halo around lights
- Seeing a glare
- Certain lights become too bright for your eyes, such as headlights, lamps or even the sunlight
- Double vision or seeing multiple images in one or both eyes
- The need to change your prescription eyeglasses frequently
It’s important to note that these symptoms might be a sign of a more serious condition in addition to or in place of cataracts. Always see a doctor for the correct diagnosis of cataracts and other eye diseases.
4. How Do Doctors Make A Cataract Diagnosis?
Although aging is mostly to blame for what causes cataracts in the eye, it can be easy to miss the warning signs. This is why you’ll want to see your eye doctor regularly to have them check for possible symptoms before it becomes a problem.
A doctor can detect cataracts by conducting a comprehensive eye exam that includes three different components:
- A visual acuity test
- A dilated eye exam
A visual acuity test is an eye chart that allows your doctor to determine how well you see at a distance. Your doctor will likely have you stand a certain length away from the chart and read a series of letters and numbers. You may be asked to cover each eye individually with your hand and then read the numbers and letters again. These figures can become larger or smaller depending on the row that your doctor has you read.
A dilated eye exam occurs when your eye doctor places drops in your eyes to widen or dilate the pupils. Using a special magnifying lens, your eye doctor will then examine your eyes to look for signs of damage and other problems. Specifically, your doctor will be checking your lens for signs of cloudiness, which is an indication of cataracts. Your pupils may remain dilated well after the exam, which may cause your close-up vision to appear blurry for several hours. Your doctor will likely give you special sunglasses to help protect your eyes while they are dilated.
A tonometry test occurs when your eye doctor uses a special tool or instrument to check the pressure inside your eyes. He or she may give you eye numbing drops for this test. When your eye is numb, your doctor may stain your eye by applying a thin strip of paper that contains a colored dye on it to the outside of your eye. This dye helps improve the accuracy of the test.
Then, your doctor will place a slit-lamp machine in front of you. You’ll rest your chin on a support and look straight into the machine. Your doctor will move the lamp toward your eye until the tip of a probe just touches your eye. The probe will flatten your cornea slightly and this is what detects the fluid pressure in your eye. This type of test is mostly used to detect glaucoma, but it may still be incorporated in your comprehensive eye exam when you get checked for cataracts.
5. What Do Cataracts Look Like?
A cataract looks like there is a cloud over your lens. If a cataract covers your entire lens, it might become hard for someone to see your pupil.
In normal and healthy eyes, the lens is clear. When you have a cataract in your eye, it appears as if the lens has a cloudy coating over the outermost layer. Depending on the size of the cataract, it can be viewed by the naked eye if your friends and family were to look for it. The beginning of cataracts might be harder to detect, especially if no cloudy filling has appeared yet.
In some cases, cataracts occur when there are clumps of proteins that cause your vision to become blurry. These might be harder to spot with the naked eye and would require an examination by a doctor.
6. Types of Cataracts
There are four primary types of cataracts, but some other types exist as well. Cataracts are classified by where and how they develop in the eye.
- Secondary cataracts: this type of cataract develops after you have had eye surgery for other problems related to the eye, including glaucoma. This type of cataracts can also occur in people who have health problems, such as diabetes, or who have taken certain medications, including some steroids.
- Traumatic cataracts: these cataracts may develop after you injure your eye. In some cases, they might not pop up until years after an eye injury.
- Radiation cataracts: radiation cataracts occur after you have been exposed to some type of radiation, such as when you are being treated for cancer.
- Congenital cataracts: congenital cataracts tend to occur in childhood. Sometimes, children are both with congenital cataracts or develop them shortly after birth. This type of cataracts does not appear to affect vision because they tend to be small. If they are big enough to affect vision, then they will need to be removed.
Other types of cataracts include the following:
- Posterior subcapsular cataract: a posterior subcapsular cataract is a type of cataract that affects the back of the lens. It tends to start as a small, opaque area that forms directly in the path of light that needs to reach the retina, which results in the inability to see bright light. It could also cause a glare or halo that occurs around nights that you see at nighttime. Posterior subcapsular cataract causes are usually related to age, personal habits such as smoking and drinking, certain medications, including steroids, and whether or not you’ve received a diabetes diagnosis. This type of cataracts tends to progress faster than other types.
- Cortical cataracts: cortical cataracts affect the outer edges of your lens. It usually beings are a white or wedge-shaped streak that is located on the outer part of your lens. As it progresses, this type of cataract may expand to the center of the eye and affect the light that passes through to the retina.
- Diabetic cataracts: diabetic cataracts occur in people who have diabetes. Research shows that diabetics are more likely to develop cataracts. However, if you have diabetes, it does not always mean that you will develop cataracts.
(Image source: http://www.kerateyeclinic.com/types-of-cataracts/)
7. Can Cataracts Cause Blindness?
If left untreated, cataracts could progress to the point where they cause blindness or total vision loss. Luckily, many forms of cataracts treatment exist, including cataract lens replacement and cataract surgery. Delaying cataract surgery and other treatments may lead to blindness.
8. Can Cataracts Be Cured?
Once you develop cataracts, surgery is the only way to cure cataracts. Some research shows that in the future, eye drops may cure cataracts without the need for surgery. One study found that lanosterol, a steroid that is naturally occurring in the body, greatly reduced the formation of protein on the lens in in-vitro and in cell-transfection experiments when given to dogs in the form of eye drops. This is exciting news for future treatments of cataracts. However, for the time being, surgery is the only option.
9. Cataract Treatment Options
Along with cataract eye surgery, cataract eye drops are a popular treatment method. You can buy over-the-counter products that are designed to help treat blurry vision. Keep in mind that this treatment option is not permanent. To date, the only way to fully treat cataracts is to remove them through a surgical procedure.
Eventually, scientists hope to be able to treat cataracts using steroid eye drops, but this treatment option is not available yet. Lubricant and clear eye drops may be able to help keep your eyes hydrated and temporarily improve your vision, but they will not cure cataracts.
10. What Is Cataract Surgery?
Cataract surgery involves removing the lens of your eye and replacing it with an artificial one. Normally, cataract surgery can be done as an outpatient procedure, which means that you won’t need to stay in the hospital afterwards. Your vision should return to normal within a short time. However, you will likely need someone to drive you home after the procedure.
Cataract surgery is performed by an eye doctor. It can be done by using an ultrasound to remove the cloudy lens or your doctor can use laser-based technology. The different types of cataract surgery are discussed later in this article.
(Image source: http://6weeks.co.uk/diagrams-of-cataract-surgery.html)
11. When To Have Cataract Surgery
Your doctor can tell you when cataract surgery is necessary. Typically, a person with cataracts will need to have surgery once the condition becomes so bad that it affects their vision as well as their daily life activities. This includes your ability to read, drive, and watch television. When this occurs, it’s best to schedule surgery right away to avoid accidents and other problems related to loss of vision.
Some people with cataracts may never need to have surgery if the problem does not affect their vision.
Your doctor may ask you the following questions to help determine whether or not you need surgery:
- Can you see well enough to drive safely and do your job?
- Does your vision affect your ability to read or watch television?
- Do you find it difficult to do housework, yard work, climb stairs, cook, or shop?
- Do you find it hard to see bright lights?
- Do colors appear dull and faded to you?
- Does your vision affect your independence? In other words, do you rely on others to help read things for you or assist you while walking and/or driving?
- Are you able to see clearly at night?
- Do you see a halo around lights or do lights affect your ability see?
12. How Much is Cataract Surgery?
You’ll want to check to see if the cataract surgery procedure is covered by your insurance. Cataract surgery cost can vary depending on your coverage.
(Image source: https://visioneyeinstitute.com.au/eyematters/does-laser-eye-surgery-hurt/)
According to some research, the cost of out-of-pocket cataract surgery is approximately $3,500 per eye. This amount reflects the portion of the surgery that is not usually covered by insurance or medicare. However, laser surgeries can be much more. The best thing to do is to get a referral by your doctor and contact your insurance company to determine what your out-of-pocket costs would be.
13. How Is Cataract Surgery Done and What Are The Types of Cataract Surgery?
Your cataract surgery options are something you should discuss with your doctor. Cataract treatment without surgery might be possible, so you always want to talk to your doctor about all of your options first. In some cases, you may not have to have surgery at all. In these instances, your doctor will likely monitor your condition to determine whether you need surgery or further treatment.
According to the American Optometric Association, there are two types of cataract surgeries. The first is small incision cataract surgery, which involves a small cut on the side of the cornea and injecting a probe into the eye. The probe sends ultrasound waves into the eye that soften the lens and breaks it up into tiny pieces. Then, the lens is suctioned out. This process is also known as phacoemulsification.
During small incision cataract surgery, your eye doctor will remove the cataract but leave the outer layer of your lens intact. The cut that the surgeon makes in your eye is so small that he or she does not usually need to use sutures to close it.
The second type of cataract surgery is known as extracapsular surgery, which occurs making a bigger cut in the corner to allow the lens to be removed in one piece. This type of surgery is often needed if the condition has become so advanced that it cannot be treated using phacoemulsification. During this procedure, your doctor will open your lens capsule (the outermost layer), remove the middle part of the lens, and keep your capsule in place.
Once your doctor removes your cloudy lens, he or she will replace it with an artificial lens called an intraocular lens. The intraocular lens is placed in the lens capsule where your natural lens was. It allows light to pass through to the back of the eye without any clouding that occurred when the cataract was in place.
There are two primary steps involved during cataract surgery:
- Step one: Laser cataract surgery
The first step of your treatment is to have surgery. Laser eye surgery for cataracts is one of the most common treatments. It is also known as Refractive Laser-Assisted Cataract Surgery (ReLACS), refractive cataract surgery, or femtosecond laser cataract surgery.
During this type of surgery, your doctor uses a handheld surgical tool or a femtosecond laser to break up the protein in the lens where the cloudy cataract is located so that it can be removed. The use of a femtosecond laser ensures that the surgery can be done with precision and accuracy. It reduces the risk of any errors during the surgery so that you can recover quickly.
- Step two: Cataract lens implant
After your doctor makes an incision and removes the affected part of your eye, he or she will implant an artificial lens. Cataract surgery with lens implant involves implanting an artificial lens where your cataract used to be. This artificial lens will act as your new lens to allow light to reach the back of your eye and enhance your vision.
14. What Does Cataract Surgery Aftercare Entail?
Your cataract surgery recovery time will depend on the severity of the condition and how well the operation went. In some cases, you may experience mild discomfort, itching, and mild fluid discharge after cataract surgery. Your eyes may also be sensitive to touch or bright lights. These symptoms should disappear after one or two days.
Your doctor may suggest that you use eye drops for approximately two weeks after surgery to speed up the healing process and reduce the risk of infection. You may also need to wear eyeglasses or eye shields to help protect your eye while it heals. It’s also important not to rub or touch your eye while it’s healing.
Research shows that it may take several weeks before your eyes are completely healed. During this time, your doctor may ask to see you regularly to make sure you are healing properly.
Here are some tips to help you while recovering at home:
- Avoid bending from the waist down to pick things up off the floor
- Don’t rub or press on your eye
- Take eye drops as directed by your doctor
- Avoid vigorous exercise
- Drink lots of water to help keep your body hydrated
Keep in mind that after your surgery, it is possible to develop a second cataract in the same eye. This occurs when the back part of your lens that was not removed during the procedure and supports the artificial lens capsule becomes cloudy and impairs your vision.
15. 19 Cataract Surgery Side Effects
If you have blurred vision after cataract surgery, then you’ll want to talk to your doctor immediately as this is not normal. After cataract surgery, your eyesight should improve quickly, but it may take some time to fully recover from the procedure.
Research shows that about 90 percent of cataract surgeries are safe and help improve your vision afterwards (1). However, some complications may exist both during and after the procedure. Common cataract surgery complications include the following:
An infection may occur in your eye after surgery if it has not been properly cared for. To reduce the risk of infection, your doctor may ask you to use eye drops that contain an antibiotic as a preventative measure. You can reduce your risk of infection by keeping the area clean and avoiding touching it. Wear protective eyeglasses to prevent getting any debris in your eye that may lead to an infection.
Slight bleeding during the procedure is normal. This may occur when your doctor makes an incision in your cornea to get to the cloudy cataract. However, if your eye begins to bleed after the surgery, then it’s best to contact your doctor immediately. Bleeding might be a sign of a more serious problem. If you don’t get it treated right away, it may cause irreversible damage.
- Inflammation or swelling
Inflammation or swelling of the eye may occur immediately following the surgery. Inflammation is your body’s way of trying to heal itself. If inflammation persists for several days and does not calm down with icing or other treatments, your doctor may want to take a look at it.
- Pain or eye discomfort
Eye discomfort is to be expected for the first day or so after your surgery. But if it keeps up and does not improve several days after your surgery, then it’s best to talk to your doctor about it. Pain may also occur during the procedure, but your doctor should be able to prescribe pain medication or numbing drops to prevent discomfort.
Redness is closely linked to inflammation. It may occur because your eye has been irritated and is trying to heal itself. Redness can either occur inside the eye or outside. Be sure to contact your doctor right away if the redness affects your vision. He or she may be able to help treat the area and keep the swelling down.
- Loss of vision
Total or partial loss of vision should not occur after surgery. If it does, then contact your doctor immediately as this may be a sign of a serious problem that is time-sensitive.
- Double vision
Double vision is another side effect of surgery that should not occur. Seek immediate help if you notice that you are seeing double or if you have any complications at all related to your eyesight.
- High or low eye pressure
You might feel pressure in your eyes as a result of the surgery, but this should not persist for more than a few days. If it does, talk to your doctor about your options. He or she may want to check you again to be sure your eye is healing properly.
In some cases, after-cataracts may occur post surgery. This is a term used to describe the condition when the cataract returns to your eye after you have had surgery to remove it, which results in blurry vision. After-cataracts may take months or years to develop, and they often require laser surgery to correct them.
- Fluid discharge from your eye
Fluid discharge may occur on its own or in addition to swelling and redness. If you experience all of these symptoms combined, seek immediate treatment. In some cases, fluid discharge may be a sign of an infection that medication will need to be administered immediately to prevent further eye damage.
- Seeing floaters or spots
Seeing floaters or spots can be a sign of high or low blood sugar. It can also be a sign of a complication due to cataract surgery. Talk to your doctor if you start to see floaters or spots after the surgery, especially if you did not see spots or floaters before. You may also want to tell your family practitioner about any spots you see if you have already been diagnosed with diabetes.
- Sensitivity to bright lights
Sensitivity to bright lights is a side effect of cataracts, but it may also occur as a result of cataract surgery. Tell your eye doctor if it becomes harder to see bright lights after your surgery or if you notice that colors suddenly appear dull.
- The inability to focus or see sharp images
It may take some time to restore the vision in your eye after surgery. However, if you notice that you are unable to focus on images or see as sharply as you once did, talk to your doctor.
- The need for glasses
You may find that you need glasses after having surgery and this may or may not be related to your cataracts. Vision has been known to naturally decline with age, and it may just be coincidental that you need glasses after cataract surgery. If you notice that your eyesight drastically declined after the surgery, your doctor may want to perform another eye exam to determine whether or not you need glasses.
- The need for a second surgery
If your doctor recommend a second surgery, it could mean that the cataracts have come back or redeveloped on the part of your lens that was not removed. It’s always best to get a second opinion if you’re concerned about having a second surgery as most surgeries should be successful the first time around.
- Dislocation of the artificial lens
If the artificial lens placed in your eye moves or becomes dislocated, contact your doctor immediately. Additionally, you should also contact your doctor if you notice that the color of your artificial lens begins to change. This could be an indication that something is wrong with the artificial lens, such as an infection or tearing of part of your eye.
- Drooping eyelid
Your eyelid may appear droopy during the procedure, especially if your doctor numbed the area beforehand. However, this effect should go away after the numbing medication wears off. If you notice that your eyelid becomes droopy several days after the procedure, then talk to your doctor.
Research shows that cataract surgery can cause a change in your eye pressure, which can eventually lead to glaucoma. Other complications that may contribute to glaucoma after cataract surgery may include infection, swelling, redness or bleeding. To prevent glaucoma, make sure you continue to get regular eye exams after your cataract surgery to catch the condition before it becomes worse.
- Retina detachment
Retina detachment is an indication that the surgery was not conducted properly or something went wrong afterwards. Retinal detachment is an emergency situation that occurs immediate attention.
Without treatment, retinal detachment may lead to permanent, irreversible vision loss. Additionally, retinal detachment might not always be obvious. If you have considerable eye pain or notice a sudden loss of vision, ask to have your eye doctor check your eyes.
16. How To Prevent Cataracts
Your risk of developing cataracts increases as you get older. Although there is nothing you can do to prevent aging, there are things you can do to help keep your eyes performing at their best.
- See your eye doctor regularly to perform regular eye exams
- Eat an anti-inflammatory diet to help provide healing nutrients to your eyes as well as the rest of your body
- Don’t smoke or drink
- Wear sunglasses to protect your eyes from the sunlight
- Avoid straining your eyes while reading or driving
- Maintain a normal blood sugar level by managing your diabetes and eating a low-sugar diet
- Avoid using oral steroids for prolonged periods of time
- Avoid going out in the sun during the brightest times of the day (wear sunglasses if you do!)
- Don’t overuse eye drops
- Stay hydrated
Cataract surgery is usually a safe procedure. However, complications may occur. Keep in mind that it may take up to eight weeks before your eyes fully recover from surgery. If you notice that you have loss of vision, excessive eye pain or inflammation, or fluid that leaks from your eye, be sure to contact your doctor immediately.