A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people.

By age 80, more than half of all people in the United States either have a cataract or have had cataract surgery. Common symptoms are Blurry vision Colors that seem faded Glare Not being able to see well at night Double vision Frequent prescription changes in your eye wear

Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts.

Cataract Overview
Cataracts are changes in clarity of the natural lens inside the eye that gradually degrade visual quality. The natural lens sits behind the colored part of the eye (iris) in the area of the pupil, and cannot be directly seen with the naked eye unless it becomes extremely cloudy. The lens plays a crucial role in focusing unimpeded light on the retina at the back of the eye. The retina transforms light to a neurologic signal that the brain interprets as vision. Significant cataracts block and distort light passing through the lens, causing visual symptoms and complaints. The term cataract is derived from the Greek word cataractos, which describes rapidly running water. When water is turbulent, it is transformed from a clear medium to white and cloudy. Keen Greek observers noticed similar-appearing changes in the eye and attributed visual loss from "cataracts" as an accumulation of this turbulent fluid, having no knowledge of the anatomy of the eye or the status or importance of the lens. Cataract development is usually a very gradual process of normal aging but can occasionally occur rapidly. Many people are in fact unaware that they have cataracts because the changes in their vision have been so gradual. Cataracts commonly affect both eyes, but it is not uncommon for cataracts in one eye to advance more rapidly. Cataracts are very common, affecting roughly 60% of people over the age of 60, and over 1.5 million cataract surgeries are performed in the United States each year. Experts have estimated that visual disability associated with cataracts accounts for over 8 million physician office visits a year in the United States. This number will likely continue to increase as the proportion of people over the age of 60 rises. When people develop cataracts, they begin to have difficulty doing activities they need to do for daily living or for enjoyment. Some of the most common complaints include difficulty driving at night, reading, participating in sports such as golfing, or traveling to unfamiliar areas; these are all activities for which clear vision is essential.

Cataract Causes
The lens is made mostly of water and protein. Specific proteins within the lens are responsible for maintaining its clarity. Over many years, the structures of these lens proteins are altered, ultimately leading to a gradual clouding of the lens. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects, and severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to occur earlier in life. Other factors that may lead to development of cataracts at an earlier age include excessive ultraviolet-light exposure, diabetes, smoking, or the use of certain medications, such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with cataracts include the long-term use of statins and phenothiazines.

Types of Cataracts
All cataracts are fundamentally a change in the clarity of the overall lens structure; however, cataracts may result either early in life or as a result of aging, and different portions of the lens may be more affected than others. Cataracts that occur at birth or present very early in life (during the first year of life) are termed congenital or infantile cataracts. These cataracts require prompt surgical correction or they may prevent the vision in the affected eye from developing normally. When the central portion of the lens is most affected, which is the most common situation, these are termed nuclear cataracts. The outside of the lens is called the lens cortex, and when opacities are most visible in this region, the cataracts are called cortical cataracts. There is an even more specific change that occasionally happens, when the opacity develops immediately next to the lens capsule, either by the anterior, or more commonly the posterior, portion of the capsule; these are called subcapsular cataracts. Unlike most cataracts, posterior subcapsular cataracts can develop rather quickly and affect vision more suddenly than either nuclear or cortical cataracts.

Cataract Symptoms
Having cataracts is often compared to looking through a foggy windshield of a car or through the dirty lens of a camera. Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty with glare (often with bright sun or automobile headlights while driving at night), dulled color vision, increased nearsightednessaccompanied by frequent changes in eyeglass prescription, and occasionally double vision in one eye. Some people notice a phenomenon called "second sight" in which one's reading vision improves as a result of their increased nearsightedness from swelling of the cataract. A change in glasses may help initially once vision begins to change from cataracts; however, as cataracts continue to progress and opacify, vision becomes cloudy and stronger glasses or contact lenses will no longer improve sight. Cataracts are usually gradual and usually not painful or associated with any eye redness or other symptoms unless they become extremely advanced. Rapid and/or painful changes in vision are suspicious for other eye diseases and should be evaluated by an eye-care professional.

Exams and Tests

To detect a cataract, the eye-care provider examines your lens. A comprehensive eye examination usually includes the following: Visual acuity test: An eye chart test is used to measure your reading and distance vision.

Refraction: Your eye doctor should determine if glasses would improve your vision. Glare testing: Vision may be significantly altered in certain lighting conditions and normal in others; in these circumstances, your doctor may check your glare symptoms with a variety of different potential lighting sources. Potential acuity testing: This helps the ophthalmologist get an idea of what your vision would be like after removal of the cataract. Think of this as the eye's vision potential if the cataract was not present. Contrast sensitivity testing: This checks for your ability to differentiate different shades of gray, which is often this limited by cataracts. Tonometry: a standard test to measure fluid pressure inside the eye (Increased pressure may be a sign of glaucoma.) Pupil dilation: The pupil is enlarged with eye drops so that the ophthalmologist can further examine the lens and retina. This is important to determine if there are other conditions which may ultimately limit your vision besides cataracts.

Cataract Treatment Surgery

The standard cataract surgical procedure is typically performed in either a hospital or in an ambulatory surgery center. The most common form of cataract surgery today is a process called phacoemulsification. With the use of an operating microscope, your surgeon will make a very small incision in the surface of the eye in or near the cornea. A thin ultrasound probe is inserted into the eye that uses ultrasonic vibrations to dissolve (phacoemulsify) the clouded lens. These tiny fragmented pieces are then suctioned out through the same ultrasound probe. Once the cataract is removed, an artificial lens is placed into the same thin capsular bag that the cataract occupied. This intraocular lens is essential to help your eye focus after surgery. There are three basic techniques for cataract surgery: Phacoemulsification: This is the most common form of cataract removal as explained above. In this most modern method, cataract surgery can usually be performed in less than 30 minutes and usually requires only minimal sedation and numbing drops, no stitches to close the wound, and no eye patch after surgery. Extracapsular cataract surgery: This procedure is used mainly for very advanced cataracts where the lens is too dense to dissolve into fragments (phacoemulsify) or in facilities that do not have phacoemulsification technology. This technique requires a larger incision so that the cataract can be removed in one piece without being fragmented inside the eye. An artificial lens is placed in the same capsular bag as with the phacoemulsification technique. This surgical technique requires a various number of sutures to close the larger wound, and visual recovery is often slower. Extracapsular cataract extraction usually requires an injection of numbing medication around the eye and an eye patch after surgery.

Intracapsular cataract surgery: This surgical technique requires an even larger wound than extracapsular surgery, and the surgeon removes the entire lens and the surrounding capsule together. This technique requires the intraocular lens to be placed in a different location, in front of the iris. This method is rarely used today but can be still be useful in cases of significant trauma.

Prevention
At present, there is no real effective way to prevent the formation of cataracts, so secondary prevention involves controlling other eye diseases that can cause cataracts and minimizing exposure to factors that promote cataracts. Wearing sunglasses outside during the day might reduce your chances of developing cataracts or having problems with the retina. Some sunglasses can filter out UV light, reducing exposure to harmful UV radiation and might slow the progression of cataracts. Some people take vitamins, minerals, and herbal extracts to decrease cataract formation. No scientific data prove that these remedies are effective. No topical or oral medications or supplements are proven to decrease the chance of developing cataracts. A healthy lifestyle might help, just as a healthy lifestyle helps prevent other diseases in the body. Eat a proper diet, get regular exercise and rest, and do not smoke. If you have diabetes, tight blood-sugar control can delay the otherwise accelerated development of cataracts.

A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. Cataracts are the most common cause of vision loss in people over age 40. In fact, there are more cases of cataracts worldwide than there are of glaucoma, macular degeneration and diabetic retinopathy combined, according to Prevent Blindness America (PBA). Today, cataracts affect more than 22 million Americans age 40 and older. And as the U.S. population ages, more than 30 million Americans are expected to have cataracts by the year 2020, PBA says. Types of cataracts include:

A subcapsular cataract occurs at the back of the lens. People with diabetes, high farsightedness or retinitis pigmentosa, or those taking high doses of steroid medications have a greater risk of developing a subcapsular cataract. A nuclear cataract forms deep in the central zone (nucleus) of the lens. Nuclear cataracts usually are associated with aging. A cortical cataract is characterized by white, wedge-like opacities that start in the periphery of the lens and work their way to the center in a spoke-like fashion. This type of cataract occurs in the lens cortex, which is the part of the lens that surrounds the central nucleus.

Cataract Symptoms and Signs

A cataract starts out small and at first has little effect on your vision. You may notice that your vision is blurred a little, like looking through a cloudy piece of glass or viewing an impressionist painting.

Hazy or blurred vision may mean you have a cataract.

A cataract may make light from the sun or a lamp seem too bright or glaring. Or you may notice when you drive at night that the oncoming headlights cause more glare than before. Colors may not appear as bright as they once did. The type of cataract you have will affect exactly which symptoms you experience and how soon they will occur. When a nuclear cataract first develops, it can bring about a temporary improvement in your near vision, called "second sight." Unfortunately, the improved vision is short-lived and will disappear as the cataract worsens. On the other hand, a subcapsular cataract may not produce any symptoms until it's well-developed. If you think you have a cataract, see an eye doctor for an exam to find out for sure.

What Causes Cataracts?

The lens inside the eye works much like a camera lens, focusing light onto the retina. It adjusts the eye's focus, letting us see things clearly both up close and far away. The lens is mostly made of water and protein. The protein is arranged in a precise way that keeps the lens clear and lets light pass through it. But as we age, some of the protein may clump together and start to cloud a small area of the lens. This is a cataract, and over time, it may grow larger and cloud more of the lens, making it harder to see. No one knows for sure why the eye's lens changes as we age, forming cataracts. Researchers are gradually identifying factors that may cause cataracts and information that may help to prevent them. Many studies suggest that exposure to ultraviolet light is associated with cataract development, so eye care practitioners recommend wearing sunglasses and a wide-brimmed hat to reduce your exposure. Other types of radiation may also be causes. For example, a 2005 study conducted in Iceland suggests that airline pilots have a higher risk of developing nuclear cataract than non-pilots and that the cause may be exposure to cosmic radiation. A similar theory suggests that astronauts, too, are at risk from cosmic radiation. Other studies suggest people with diabetes are at risk for developing a cataract. The same goes for users of steroids, diuretics and major tranquilizers, but more studies are needed to distinguish the effect of the disease from the consequences of the drugs themselves. Some eye care practitioners believe that a diet high in antioxidants, such as beta-carotene (vitamin A), selenium and vitamins C and E, may forestall cataract development. Meanwhile, eating a lot of salt may increase your risk. Other risk factors include cigarette smoke, air pollution and heavy alcohol consumption.

A small study published in 2002 found lead exposure to be a risk factor; another study in December 2004, of 795 men age 60 and older, came to a similar conclusion.

But larger studies are needed to confirm whether lead can definitely put you at risk and, if so, whether the risk is from a one-time dose at a particular time in life or from chronic exposure over years.* Researchers say additional studies also are needed to confirm whether hormone replacement therapy (HRT) significantly increases chances that cataracts will form and progress to the point that surgical removal is required. An eight-year study of more than 30,000 postmenopausal Swedish women found a 14 percent increased risk for cataract removal among those who used HRT at any time and an 18 percent increased risk for current HRT users. HRT use combined with regular alcohol consumption appeared to create a 42 percent increased risk of cataract removal, compared with women who had never used HRT or alcohol. The HRT study was reported in the March 2010 issue of Ophthalmology. Does Eating Less Meat Reduce Your Risk for Cataracts?

Could eating more greens and less meat help you delay the onset of cataracts?

This interesting question has received a lot of public comment since researchers at the University of Oxford published a study** in March 2011 that compared cataract incidence with dietary intake. The study examined the dietary surveys filled out by 27,670 self-reported nondiabetic people aged 40 or over and monitored their medical records to see if and when cataracts developed. Strong correlations showed up between cataract risk and diet type. The risk was greatest for high meat eaters (who ate more than 3.5 ounces of meat each day), and it decreased from one group to the next, in this order: moderate meat eaters, low meat eaters, fish eaters (people who eat fish but no other meat), vegetarians and vegans. In fact, the risk for vegans was roughly 40 percent lower than for the high meat eaters. Does this mean you should stop eating meat? Maybe, maybe not. The study doesn't answer every question. Perhaps the reason for the lower risk is that if you eat less meat, you probably eat more vegetables. And perhaps those veggies are providing nutrients that reduce cataract risk. Also, vegetarians and vegans may tend to lead healthy lifestyles, avoiding cataract risk boosters such as smoking, excess sun exposure and diabetes. It may be true that cataracts are inevitable if you live long enough, but living healthy just might delay them for a good long time. L.S.

Cataract Treatment
When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, strong bifocals, magnification, appropriate lighting or other visual aids. Think about surgery when your cataracts have progressed enough to seriously impair your vision and affect your daily life. Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain vision. Cataract surgery is very successful in restoring vision. In fact, it is the most frequently performed surgery in the United States, with more than 3 million Americans undergoing cataract surgery each year. Nine out of 10 people who have cataract surgery regain very good vision, somewhere between 20/20 and 20/40. During surgery, the surgeon will remove your clouded lens and in most cases replace it with a clear, plastic intraocular lens (IOL). New IOLs are being developed all the time to make the surgery less complicated for surgeons and the lenses more helpful to patients. Presbyopia-correcting IOLs potentially help you see at all distances, not just one. Another new type of IOL blocks both ultraviolet and blue light rays, which research indicates may damage the retina (see illustration).

Read more: http://www.allaboutvision.com/conditions/cataracts.htm#ixzz1SDqXMDYJ

What are risk factors for cataracts?

Advanced age is a significant risk factor for the development of cataracts. A family history for early development of cataracts, the presence of diabetes, tobacco use, and prolonged exposure to sunlight are also risk factors.

What are the symptoms of cataracts?

You may not notice any symptoms with early cataracts. As a cataract becomes more advanced, decrease in clarity of vision, not fully correctable with glasses, is noticed. There is a loss of contrast sensitivity, so that shadows and color vision are less vivid. Disturbing glare may be noted as light is into the eye scattered by the cataract. Haloes may be observed around lights. Night vision will be diminished. In certain types of cataracts, double vision may be noted in the affected eye. Some patients note that they require frequent changes in their eyeglass orcontact lens prescriptions and may be aware that their near vision is improving as their distance vision declines. A cataract does not routinely cause discomfort or pain in the eye or alter the external appearance of the eye

What are the signs of cataracts?

Family members of a person affected by cataracts in both eyes may notice he or she appears not to be seeing as well as previously. The eye will appear normal to the untrained observer, unless the cataract is mature and white. In that situation the pupil of the eye, which normally appears black, will look grey or white to the observer. The examining physician will find diminished visual acuity in the affected eye or eyes. This visual loss is not fully corrected by a change in the glasses. The lens of the eye can be easily examined by an ophthalmologist and the changes in the lens characteristic of cataract can actually be seen using

a slit lamp, which is an illuminating and magnifying device used to painlessly examine the structures within the front of the eye, including the lens.

How are cataracts diagnosed?

Cataracts are relatively simple to diagnose by an ophthalmologist or an optometrist during a routine eye examination. It is important, when making the diagnosis of cataract, to also examine the entire eye for evidence of any other eye disease which may be compromising the vision. In addition to taking a medical and ocular history and visual acuity test, the ophthalmologist will check eye movements and pupillary responses, measure the pressure inside the eyes and examine the front and back of the eyes after the pupils have been dilated with drops.

What is the treatment for cataracts?

People with early cataract will find that changing their glasses, using sunglasses to decrease glare and having better lighting to read can significantly alleviate their symptoms. Magnifying lenses for close work and reading fine print may also be helpful. Many cataracts are not bothersome, causing few symptoms. In that situation, no surgical treatment is necessary. However, the only true treatment for cataract is surgical removal of the cloudy lens. Surgery is suggested if the patient loses the ability to perform necessary activities of everyday life, such as driving, reading, or looking at computer or video screens, even with glasses, and there is the expectation that vision will improve as a result of the surgery. Depending on a patient's specific visual needs, surgery is sometimes done on cataracts that are not very dense or surgery can wait until the cataract and the vision gets more cloudy. Patients' responses to cataracts vary. A cataract in only one eye may be disturbing to a particular patient and may not cause significant symptoms in another patient. Cataracts usually do not harm your eye, so you can have surgery when it is convenient for you. Once you understand the benefits and risks of surgery, you can make an informed decision about whether cataract surgery is right for you. In most cases, delaying cataract surgery will not cause long-term damage to your eye or make the surgery more difficult. If the eye has other diseases that have caused visual loss such asglaucoma, macular degeneration, diabetic retinopathy, or optic nerve damage from glaucoma, cataract surgery may not improve the vision. Occasionally, your doctor may recommend removal of a cataract if it prevents diagnosis or treatment of another eye problem, such as macular degeneration or diabetic retinopathy. If both eyes have cataracts and surgery is agreed upon, the surgery on the second eye is generally planned at least a week after the first eye. There is usually no harm in waiting a much longer period of time between the two eye operations. Since the lens of the eye is necessary to accurately focus light onto the retinal surface and removal of the cataract involves removal of the lens, modern cataract surgery combines removal of the lens with placement of a new artificial lens into the eye. Measurements for the size, shape, and power of

this lens will be taken at least a week prior to the surgery so that the lens can be ordered and available at the time of surgery. More than 2 million cataract surgeries are performed annually in the United States. It is extremely safe and effective, improving vision in the vast majority of patients.

What are the different types of cataract surgery, and what risks are involved?
Cataract surgery is usually performed as an outpatient procedure under local anesthesia. Some sedation is ordinarily given intravenously just before the beginning of the surgery, which usually takes under a half-hour. Most cataract surgery today is done through a small incision by phaco-emulsification or by other extracapsular means through a slightly larger incision. In more than 95% of cases, a new lens, known as a lens implant or intraocular lens is inserted at the same time as the cataract removal. You will not feel the new lens within the eye. Most patients need to limit their activities for only a few days and recovery time is brief. Although modern techniques have made cataract surgery quite safe, complications can occur with any surgical procedure, including cataract extraction. These include hemorrhage, infection, loss of a portion of the cataract into the eye, displacement of the intraocular lens, glaucoma, and retinal detachment. Fortunately, all these complications are rare and usually can be managed. Blindness is a rare complication of cataract surgery. Modern cataract surgery involves leaving a portion of the lens capsule within the eye to support the intraocular lens. This capsule may become cloudy at a later time, necessitating opening of the capsule through the use of a laser. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems.

What are complications of cataracts?

Occasionally, a very dense cataract of long-standing duration may enlarge in size and interfere with fluid drainage within the eye. In addition, a far advanced cataract may leak protein into the eye, causing inflammation of the eye. Your doctor will advise you of these possibilities and may recommend surgery to avoid these complications even if the decrease in vision is not bothering you. The presence of a cataract may make evaluation of diseases of the retina more difficult, since the physician must look through the cataract to examine the retina.

What is a cataract?
A cataract is an eye disease in which the clear lens of the eye becomes cloudy opaque, causing decrease in vision. Although the word cataract to describe this condition has been part of the English language only since the middle of the 16th century, the eye disease has been recognized and surgically treated since ancient times.

The lens is a portion of the eye that is normally clear. It assists in focusing rays of light entering the eye onto the retina, the light-sensitive tissue at the back of the eye. In order to get a clear image onto the retina, the portions of the eye in front of the retina, including the lens, must be clear and transparent. Once light reaches the retina, the light initiates a chemical reaction within the retina. The chemical reaction, in turn, initiates an electrical response which is carried to the brain through the optic nerve. The brain then interprets what the eye sees. In a normal eye, light passes through the transparent lens to the retina. The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image striking the retina will be blurry and the vision will be blurry. The extent of the visual disturbance is dependent upon the degree of cloudiness of the lens. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have some degree of cataract or have already undergone cataract surgery in one or both eyes. By age 95, this percentage increases to almost 100%. A cataract can occur in either or both eyes. Individuals with a cataract in one eye usually go on to develop a cataract in the other eye as well. A cataract is not contagious and cannot spread from one eye to the other or from person to person. Cataracts do not cause the eye to tear abnormally. They are neither painful nor make the eye itchy or red. Although vision can be restored in most people with cataracts, age-related cataracts are still the most common cause of blindness in the world, primarily because many third-world nations lack appropriate surgical services.

As life span increases in the developed world due to modern technology and new methods of treatment of acute and chronic disease, the incidence of age-related cataracts will continue to increase.

What are the different types of cataracts?

Cataracts can be classified by anatomical location within the lens, degree of clouding of the lens, or by the cause of the cataract. The lens of the human eye is shaped similar to an M&M's candy. It has a front (anterior) part and a back (posterior) part. The central portion of the lens is called the lens nucleus, and the outer portion is called the lens capsule. Between the inner nucleus and the outer capsule is a portion of the lens called the cortex. Clouding of the lens can occur only in the nucleus, in which case the termnuclear cataract or nuclear sclerosis is used. If the clouding occurs in the lens cortex only, the cataract is termed a cortical cataract. If the loss of clarity of the lens is primarily in the capsule, the term subcapsular cataract is used. The location of the clouding can also be defined as being anterior or posterior, central, or peripheral. Often the clouding of the lens may affect multiple portions of the lens. The most common type of cataract that is related to age is sometimes termed asenile cataract. This type of cataract primarily involves the nucleus of the lens. Cataracts that develop in the posterior subcapsular area (in the rear region of the lens capsule) are more common in a younger age group. Any degree of loss of the normal transparency of the lens is called a cataract. The more cloudy the, lens the more advanced the degree of cataract. A cataract may be mild, moderate, or severe. It may be early or advanced. If the lens is totally opaque it is termed a "mature" cataract. Any cataract that is not opaque is therefore termed an "immature" cataract. Most mature cataracts are white in color.

What are causes of cataracts?

The lens is made of mostly water and protein. The protein is arranged in a specific way that keeps the lens clear and allows light to pass through it to focus a clear image onto the retinal surface. As we age, some of the protein may clump together and start to cloud a small area of the lens. This is our understanding of the cause of an age-related cataract. Over time, the cataract may become more dense or cloud more of the lens, making it more difficult to see through. A cataract is not a growth or tumor. There are many causes of non age-related cataracts or secondary cataracts. Secondary cataracts are a result of similar changes to the protein of the lens, also resulting in visual blurring or visual loss. Blunt or penetrating injury to the eye may cause secondary cataracts, either immediately after the injury or some weeks to years afterward. A cataract following an injury may appear and then not increase in density (be stationary) or be progressive. Eye surgery for other conditions can also cause cataracts. Excessive exposure to ionizing radiation (X-ray), infrared radiation (as in glass blowers), or ultraviolet radiation cause secondary cataracts.

Diabetes is associated with the development of secondary cataracts. Inflammatory disease of the eye, such as iritis or uveitis, may cause or accelerate the development of cataract in the involved eye. There are many genetic illnesses that are associated with the development of secondary cataracts. These include myotonic dystrophy, galactosemia, homocystinuria, Wilson's disease and Down syndrome, plus many others. Congenital infections with herpes simplex, rubella, toxoplasmosis, syphilis, and cytomegalic inclusion disease may also result in cataracts. There are many medications which, when taken over a long period of time, can cause secondary cataracts. The most common of these are oral corticosteroids, such as prednisone, which are used for a wide variety of medical conditions. The term "congenital cataract" is used when a baby is born with any clouding of the lens. This may be present in one or both eyes, be stationary or be progressive. Causes include genetic disorders or intrauterine developmental disorders, both often associated with other physical abnormalities of the baby. Atopic dermatitis, other diseases of the skin and mucous membranes,hypothyroidism, and hyperparathyroidism are associated with the early development of cataracts. Patients who develop cataracts in both eyes at an early age often have family members who have also developed cataracts prematurely, implying a genetic cause, even in the absence of a recognized underlying disease.

Definition
A cataract is a clouding of the normally clear lens of your eye. For people who have cataracts, seeing through cloudy lenses is a bit like looking through a frosty or foggedup window. Clouded vision caused by cataracts can make it more difficult to read, drive a car especially at night or see the expression on a friend's face. Most cataracts develop slowly and don't disturb your eyesight early on. But with time, cataracts will eventually interfere with your vision. At first, stronger lighting and eyeglasses can help you deal with cataracts. But if impaired vision interferes with your usual activities, you might need cataract surgery. Fortunately, cataract surgery is generally a safe, effective procedure.

Symptoms
Signs and symptoms of cataracts include:

Clouded, blurred or dim vision

Increasing difficulty with vision at night Sensitivity to light and glare Seeing "halos" around lights Frequent changes in eyeglass or contact lens prescription Fading or yellowing of colors Double vision in a single eye

At first, the cloudiness in your vision caused by a cataract may affect only a small part of the eye's lens and you may be unaware of any vision loss. As the cataract grows larger, it clouds more of your lens and distorts the light passing through the lens. This may lead to signs and symptoms you're more likely to notice. When to see a doctor Make an appointment for an eye exam if you notice any changes in your vision. If you develop sudden vision changes, such as double vision or blurriness, see your doctor right away.

Causes
Most cataracts develop when aging or injury changes the tissue that makes up your eye's lens. Some cataracts are caused by inherited genetic disorders that cause other health problems and increase your risk of cataracts. How a cataract forms The lens, where cataracts form, is positioned behind the colored part of your eye (iris). The lens focuses light that passes into your eye, producing clear, sharp images on the retina the light-sensitive membrane on the back inside wall of your eyeball that functions like the film of a camera. A cataract scatters the light as it passes through the lens, preventing a sharply defined image from reaching your retina. As a result, your vision becomes blurred. As you age, the lenses in your eyes become less flexible, less transparent and thicker. Aging-related changes to the lens cause tissues to break down and to clump together, clouding small areas of the lens. As the cataract continues to develop, the clouding becomes denser and involves a greater part of the lens. A cataract can develop in one or both of your eyes. Types of cataracts Cataract types include:

Cataracts that affect the center of the lens (nuclear cataracts). A nuclear cataract may at first cause you to become more nearsighted or even experience a temporary improvement in your reading vision. But with time, the lens gradually turns more densely yellow and further clouds your vision. Nuclear cataracts sometimes cause you to see double or multiple images. As the cataract progresses, the lens may even turn brown. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of color.

Cataracts that affect the edges of the lens (cortical cataracts). A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it slowly progresses, the streaks extend to the center and interfere with light passing through the center of the lens. Problems with glare are common for people with this type of cataract.

Cataracts that affect the back of the lens (posterior subcapsular cataracts). A posterior subcapsular cataract starts as a small, opaque area that usually forms near the back of the lens, right in the path of light on its way to the retina. A subcapsular cataract often interferes with your reading vision, reduces your vision in bright light and causes glare or halos around lights at night.

Cataracts you're born with (congenital cataracts). Some people are born with cataracts or develop them during childhood. Such cataracts may be the result of the mother having contracted an infection during pregnancy. They may also be due to certain inherited syndromes, such as Alport's syndrome, Fabry's disease and galactosemia. Congenital cataracts, as they're called, don't always affect vision, but if they do they're usually removed soon after detection.

Risk factors
Factors that increase your risk of cataracts include:

Increasing age Diabetes Drinking excessive amounts of alcohol Excessive exposure to sunlight Exposure to ionizing radiation, such as that used in X-rays and cancer radiation therapy Family history of cataracts High blood pressure Obesity

Previous eye injury or inflammation Previous eye surgery Prolonged use of corticosteroid medications Smoking

Tests and diagnosis

To determine whether you have a cataract, your doctor will perform an eye exam that may include:

Asking you to read an eye chart (visual acuity test). A visual acuity test uses an eye chart to measure how well you can read a series of letters. Your eyes are tested one at a time, while the other eye is covered. Using a chart or a viewing device with progressively smaller letters, your eye doctor determines if you have 20/20 vision or if your vision shows signs of impairment.

Using a light and magnification to examine your eye (slit-lamp examination). A slit lamp allows your eye doctor to see the structures at the front of your eye under magnification. The microscope is called a slit lamp because it uses an intense line of light a slit to illuminate your cornea, iris, lens, and the space between your iris and cornea. The slit allows your doctor to view these structures in small sections, which makes it easier to detect any tiny abnormalities.

Dilating your eyes (retinal examination). To prepare for a retinal examination, your eye doctor puts dilating drops in your eyes to open your pupils wide. This makes it easier to examine the back of your eyes (retina). Using a slit lamp or a special device called an ophthalmoscope, your eye doctor can examine your lens for signs of a cataract.

Treatments and drugs

Cataract surgery

The only effective treatment for cataracts is surgery. When to consider cataract surgery Talk with your eye doctor about whether surgery is right for you. Most eye doctors suggest considering cataract surgery when your cataracts begin to affect your quality of life or interfere with your ability to perform normal daily activities, such as reading or driving at night.

It's up to you and your doctor to decide when cataract surgery is right for you. For most people, there is no rush to remove cataracts because they usually don't harm the eye. Delaying the procedure won't make it more likely that you won't recover your vision if you eventually decide to have cataract surgery. Take time to consider the benefits and risks of cataract surgery with your doctor. If you choose not to undergo cataract surgery for now, your eye doctor may recommend periodic follow-up exams to see if your cataracts are progressing. How often you'll see your eye doctor depends on your situation. What happens during cataract surgery Cataract surgery involves removing the clouded lens and replacing it with a plastic lens implant. The replacement lens sits in the same place as your natural lens and becomes part of your eye. For some people, other eye problems prohibit the use of a replacement lens. In these situations, once the cataract is removed, vision can be corrected with eyeglasses or contact lenses. Surgery is usually done on one eye at a time, with a few weeks between surgeries. It's generally done on an outpatient basis, which means you won't need to stay in a hospital after the surgery. During cataract surgery your eye doctor uses local anesthesia to numb the area around your eye, but you stay awake during the procedure. Cataract surgery is generally safe, but carries a risk of infection and bleeding. Cataract surgery increases the risk of retinal detachment.

Lifestyle and home remedies

To deal with symptoms of cataracts until you decide to have surgery, try to:

Make sure your eyeglasses or contact lenses are the most accurate prescription possible Use a magnifying glass to read Improve the lighting in your home with more or brighter lamps When you go outside during the day, wear sunglasses or a broad-brimmed hat to reduce glare Limit your night driving

Self-care measures may help for a while, but as the cataract progresses, your vision may deteriorate further. When vision loss starts to interfere with your everyday activities, consider cataract surgery.

Prevention
It's not clear what causes cataracts, but doctors think you may be able to reduce your risk of cataracts if you:

Have regular eye exams. Eye exams can help detect cataracts and other eye problems at their earliest stages. Ask your doctor how often you should have an eye exam.

Quit smoking. Ask your doctor for help to stop smoking. Medications, counseling and other strategies are available to help you.

Wear sunglasses. Ultraviolet light from the sun may contribute to the development of cataracts. Wear sunglasses that block ultraviolet B (UVB) rays when you're outdoors.

Take care of other health problems. Follow your treatment plan if you have diabetes or other medical conditions that can increase your risk of cataracts.

Maintain a healthy weight. If your current weight is a healthy one, work to maintain it by exercising most days of the week. If you're overweight or obese, work to lose weight slowly by reducing your calorie intake and increasing the amount of exercise you get each day.

Choose a healthy diet that includes plenty of fruits and vegetables. Adding a variety of colorful fruits and vegetables to your diet ensures that you're getting a lot of vitamins and nutrients. Fruits and vegetables are full of antioxidants, which in theory could prevent damage to your eye's lens. Studies haven't proven that antioxidants in pill form can prevent cataracts. But fruits and vegetables have many proven health benefits and are a safe way to increase the amount of vitamins in your diet.