Cataract
Co-Management

Cataract Diagnosis & Co-Management, Marion, OH

A cataract is a cloudy or opaque area in the normally clear lens of the eye. Depending on its size and location, it can interfere with normal vision. Most cataracts develop in people over age 55, but they occasionally occur in infants and young children. At Buckeye Optometry in Marion, OH, our team of eye care professionals can diagnose cataracts and recommend treatment to prevent vision loss. If surgery is needed, we will refer you to a trusted ophthalmologist and provide you with pre- and post-operative care.

What are the different types of cataracts?

The lens is located inside the eye behind the iris, the colored part of the eye. It works like a camera lens to focus light on the back of the eye, the retina. The lens is made of mostly proteins and water. Clouding of the lens occurs due to changes in the proteins and lens fibers.

The lens is composed of layers like an onion: the outermost layer is the capsule, the middle layer is the cortex, and the innermost layer is the nucleus. A cataract may develop in any of these areas and is classified based on its location in the lens:

• A cortical cataract affects the middle layer of the lens. It is identified by its unique wedge or spoke appearance.
• A nuclear cataract is located in the center of the lens. The nucleus tends to darken, changing from clear to yellow and sometimes brown.
• A posterior capsular cataract is found in the back outer layer of the lens. This type often develops more rapidly.

Normally, the lens focuses light on the retina, which sends the image through the optic nerve to the brain. However, if the lens is clouded by a cataract, light is scattered so the lens can no longer focus properly, causing vision problems.

What are the symptoms of cataracts?

Cataracts generally form very slowly. Symptoms of a cataract may include:

• Blurred or hazy vision
• The colors of objects may not appear as bright, or it may be more difficult to distinguish between certain colors
• Increased sensitivity to glare from lights, particularly when driving at night
• Seeing multiple images
• Difficulty seeing at night
• Temporary improvement in near vision

While the process by which cataracts form is becoming more clearly understood, there is currently no established clinical treatment to prevent or slow their progression. In age-related cataracts, vision changes can be so gradual that some people may not initially notice any vision changes. As cataracts worsen, however, vision symptoms tend to become more severe.

What causes cataracts?

Most cataracts are due to age-related changes in the lens. However, other factors can contribute to their development, including:

• Diabetes mellitus: People with diabetes are at higher risk for cataracts.
• Drugs: Certain medications have been linked to cataract development, including corticosteroids, phenothiazine or other thiazines, and chlorpromazine.
• Ultraviolet radiation: Several studies have found that exposure to ultraviolet (UV) radiation without eye protection can increase your risk of developing cataracts. 
• Smoking: People who smoke are two to three times more likely to develop cataracts than people who don’t smoke, according to the U.S. Department of Health and Human Services.
• Alcohol: Studies have shown that people who consume more alcohol are more likely to develop cataracts than those with lower or no alcohol consumption.
• Nutrition: Although the results are inconclusive, studies have suggested a link between cataract formation and low levels of antioxidants (e.g., vitamin C, vitamin E, and carotenoids). Further studies may show that antioxidants have a significant effect on decreasing the incidence of cataract development.

Rarely, cataracts can be present at birth or develop shortly after. They may be inherited or develop due to an infection in the mother, such as rubella, during pregnancy. A cataract may also develop following an eye injury or surgery for another eye problem, such as glaucoma.

How is a cataract diagnosed?

At Buckeye Optometry in Marion, your eye doctor can diagnose cataracts and a range of other eye diseases during a comprehensive eye exam. This examination may include:

• Patient history to identify any vision difficulties that may limit a patient’s daily activities, as well as other general health concerns that may affect their vision.
• Visual acuity measurement to determine the extent to which a cataract may be limiting clear vision at both distance and near ranges.
• Refraction to assess whether changes are needed in the eyeglass or contact lens prescription.
• Evaluation of the lens under high magnification and illumination to determine the extent and location of any cataracts.
• Dilation of the pupils to evaluate the retina.
• Measurement of pressure within the eye.
• Supplemental testing for color vision and glare sensitivity.

Further testing may be necessary to determine the degree of vision impairment caused by a cataract and to assess whether other eye conditions may affect vision after cataract surgery.

Using the information obtained from these tests, your optometrist can determine if you have cataracts and advise you on options for treatment.

How is a cataract treated?

Treatment for cataracts is based on the level of visual impairment they cause. If a cataract affects vision only minimally or not at all, no treatment may be needed. For these patients, our eye doctor may recommend monitoring their symptoms for vision changes and following a regular check-up schedule.

In some cases, a change in eyeglass prescription may temporarily improve visual acuity. Additionally, increasing the amount of light used when reading and the use of anti-glare coatings on clear lenses can help reduce glare for night driving.

When a cataract progresses to the point where it affects a person’s ability to do everyday tasks, then surgery may be needed. Cataract surgery involves removing the lens of the eye and replacing it with an artificial lens. The artificial lens requires no care and can significantly improve vision. New artificial lens options include those that simulate the natural focusing ability of a young healthy lens.

Two approaches to cataract surgery are generally used:

• Small incision cataract surgery involves making an incision in the side of the cornea, the clear outer covering of the eye, and inserting a tiny probe into the eye. The probe emits ultrasound waves that soften and break up the lens so it can be removed by suction. This process is called phacoemulsification.
• Extracapsular surgery requires a somewhat larger incision in the cornea and the lens is removed in one piece.

Once the natural lens has been removed, it is replaced by a clear plastic lens called an intraocular lens (IOL). If implanting an IOL is not possible due to other eye issues, contact lenses and occasionally eyeglasses may be considered as an alternative to correct vision.

As with any surgical procedure, cataract surgery carries the risk of infection and bleeding. Cataract surgery also slightly increases the risk of retinal detachment. It is important to discuss the benefits and risks of cataract surgery with your eye care providers. Other ocular conditions may increase the need for cataract surgery or prevent a person from being a cataract surgery candidate.

Cataract surgery is one of the safest and most effective types of surgery performed in the United States today. Approximately 90 percent of cataract surgery patients report better vision following the surgery.

How can you prevent cataracts?

Although there are no clinically proven methods for preventing cataracts, a simple, low-cost, and low-risk strategy is to reduce sunlight exposure, quit or decrease smoking, and increase the intake of antioxidant vitamins by consuming leafy green vegetables and nutritional supplements. You can also lower your risk by managing any preexisting conditions like diabetes and using protective eyewear when engaging in sports or other potentially dangerous activities.

The best form of prevention is to schedule regular comprehensive eye exams with a qualified optometrist. Our eye care experts are experienced in diagnosing cataracts and providing pre- and post-operative care for cataract surgery. If you are concerned about cataracts, contact us today to schedule your comprehensive eye exam at our office in Marion, OH.