CATARACT

General Information

DEFINITION--A clouding of the lens of the eye. The lens is a crystal-clear, flexible structure near the front of the eyeball. It helps to keep vision in focus and screens and refracts light rays. The lens has no blood supply. It is nourished by the vitreous (watery substance that surrounds it). If hardening of the arteries prevents proper nourishment of the vitreous--as often occurs in aging--the lens loses its nourishment also. The lens may then become less transparent and flexible and form cataracts. Cataracts may form in one or both eyes. If they form in both eyes, their growth rate may be very different. Cataracts are not cancerous.

BODY PARTS INVOLVED--Lens of the eye(s).

SEX OR AGE MOST AFFECTED

• Adults over 60.
• Newborns (congenital form only).

SIGNS & SYMPTOMS

• Blurred vision that may be worse in bright light. The blurring may first become apparent to one while driving at night, when lights seem to scatter or have halos.
• Double vision (occasionally).
• Opaque, milky-white pupil (advanced stages only).

CAUSES

• Natural aging.
• Injury to the eye.
• Illnesses associated with high blood sugar, such as diabetes mellitus.
• Inflammation, such as uveitis (inflammation of the parts of the eyes that make up the iris).
• Drugs, especially cortisone and its derivatives.
• Exposure to x-rays, microwaves and infrared radiation.
• Hereditary causes, including the effect of German measles on the unborn child of a mother who contracts the disease early in pregnancy.
• Galactosemia (See Glossary) in an infant.

RISK INCREASES WITH

• Adults over 60.
• Exposure to any causes listed above.

HOW TO PREVENT

• The use of cortisone drugs or any others that affect the eye lens should be monitored carefully by a doctor.
• Eye disorders that may cause cataract formation, such as iritis and uveitis, should receive prompt medical treatment.
• Ultraviolet protecting glasses (in sunny climates) may slow progression of cataract.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Eye examination with ophthalmoscopy.

APPROPRIATE HEALTH CARE

• Doctor's (ophthalmologist's) treatment.
• Surgery to remove the lens if vision deteriorates or cataract causes inflammation and pressure in the eye. Many different methods are in use today for anesthesia, hospitalization, and correction of vision after surgery. Surgery may be done on an inpatient or outpatient basis. Usually one eye is operated on at a time (if cataracts are in both eyes). (See Cataract Removal with Intraocular Lens Replacement in Surgery section.)

POSSIBLE COMPLICATIONS

• Loss of vision.
• Postoperative complications, including rupture of the eye, adhesions, infections and retinal detachment.

PROBABLE OUTCOME--Usually curable with surgery. Some cataracts never impair vision enough to require surgery. During the time cataracts are forming, frequent eyeglass changes may help vision.

How To Treat

GENERAL MEASURES--

• Consider surgery when your vision problems interfere with your lifestyle: lack of confidence when driving, can't read comfortably, unable to do your best work, prevented from doing things you want to do, afraid of falling, not as independent as you want to be, just can't see well enough (even with glasses).
• For a description of cataract surgery and postoperative care, see Cataract Removal (in Surgery section). Special eyeglasses or contact lenses will be needed after surgery.

MEDICATION--Medicine usually is not necessary for this disorder.

ACTIVITY--No restrictions, except don't drive at night if your vision is poor.

DIET--No special diet.

Call Your Doctor If

You have symptoms of cataracts.