June is Cataract Awareness Month

What is a cataract?

A cataract is a clouding of the lens in the eye that affects vision. Most cataracts are related to aging. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.

A cataract can occur in either or both eyes. It cannot spread from one eye to the other.

anatomy of the eye

What is the lens?

The lens is a clear part of the eye that helps to focus light, or an image, on the retina. The retina is the light-sensitive tissue at the back of the eye.

In a normal eye, light passes through the transparent lens to the retina. Once it reaches the retina, light is changed into nerve signals that are sent to the brain.

The lens must be clear for the retina to receive a sharp image. If the lens is cloudy from a cataract, the image you see will be blurred.

Are there other types of cataract?

Yes. Although most cataracts are related to aging, there are other types of cataract:

  1. Secondary cataract. Cataracts can form after surgery for other eye problems, such as glaucoma. Cataracts also can develop in people who have other health problems, such as diabetes. Cataracts are sometimes linked to steroid use.
  2. Traumatic cataract. Cataracts can develop after an eye injury, sometimes years later.
  3. Congenital cataract. Some babies are born with cataracts or develop them in childhood, often in both eyes. These cataracts may be so small that they do not affect vision. If they do, the lenses may need to be removed.
  4. Radiation cataract. Cataracts can develop after exposure to some types of radiation.

Causes and Risk Factors

What causes cataracts?

How someone with cataracts might see two children holding balls. National Eye Institute, National Institutes of Health

How someone with cataracts might see two children holding balls. Photo courtesy of National Eye Institute, National Institutes of Health

The lens lies behind the iris and the pupil. It works much like a camera lens. It focuses light onto the retina at the back of the eye, where an image is recorded. The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is made of mostly 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. Over time, the cataract may grow larger and cloud more of the lens, making it harder to see.

Researchers suspect that there are several causes of cataract, such as smoking and diabetes. Or, it may be that the protein in the lens just changes from the wear and tear it takes over the years.

How can cataracts affect my vision?

Age-related cataracts can affect your vision in two ways:

  1. Clumps of protein reduce the sharpness of the image reaching the retina.The lens consists mostly of water and protein. When the protein clumps up, it clouds the lens and reduces the light that reaches the retina. The clouding may become severe enough to cause blurred vision. Most age-related cataracts develop from protein clumpings.When a cataract is small, the cloudiness affects only a small part of the lens. You may not notice any changes in your vision. Cataracts tend to “grow” slowly, so vision gets worse gradually. Over time, the cloudy area in the lens may get larger, and the cataract may increase in size. Seeing may become more difficult. Your vision may get duller or blurrier.
  2. The clear lens slowly changes to a yellowish/brownish color, adding a brownish tint to vision.As the clear lens slowly colors with age, your vision gradually may acquire a brownish shade. At first, the amount of tinting may be small and may not cause a vision problem. Over time, increased tinting may make it more difficult to read and perform other routine activities. This gradual change in the amount of tinting does not affect the sharpness of the image transmitted to the retina.If you have advanced lens discoloration, you may not be able to identify blues and purples. You may be wearing what you believe to be a pair of black socks, only to find out from friends that you are wearing purple socks.

When are you most likely to have a cataract?

The term “age-related” is a little misleading. You don’t have to be a senior citizen to get this type of cataract. In fact, people can have an age-related cataract in their 40s and 50s. But during middle age, most cataracts are small and do not affect vision. It is after age 60 that most cataracts steal vision.

Who is at risk for cataract?

The risk of cataract increases as you get older. Other risk factors for cataract include:

  • Certain diseases such as diabetes.
  • Personal behavior such as smoking and alcohol use.
  • The environment such as prolonged exposure to sunlight.

What can I do to protect my vision?

Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. They recommend eating green leafy vegetables, fruit, and other foods with antioxidants.

If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. In addition to cataract, your eye care professional can check for signs of age-related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight.

Symptoms and Detection

What are the symptoms of a cataract?

The most common symptoms of a cataract are:

  • Cloudy or blurry vision.
  • Colors seem faded.
  • Glare. Headlights, lamps, or sunlight may appear too bright. A halo may appear around lights.
  • Poor night vision.
  • Double vision or multiple images in one eye. (This symptom may clear as the cataract gets larger.)
  • Frequent prescription changes in your eyeglasses or contact lenses.
  • These symptoms also can be a sign of other eye problems. If you have any of these symptoms, check with your eye care professional.

How is a cataract detected?

Cataract is detected through a comprehensive eye exam that includes:

  1. Visual acuity test. This eye chart test measures how well you see at various distances.
  2. Dilated eye exam. Drops are placed in your eyes to widen, or dilate, the pupils. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.
  3. Tonometry. An instrument measures the pressure inside the eye. Numbing drops may be applied to your eye for this test.

Your eye care professional also may do other tests to learn more about the structure and health of your eye.

Treatment

How is a cataract treated?

The symptoms of early cataract may be improved with new eyeglasses, brighter lighting, anti-glare sunglasses, or magnifying lenses. If these measures do not help, surgery is the only effective treatment. Surgery involves removing the cloudy lens and replacing it with an artificial lens.

A cataract needs to be removed only when vision loss interferes with your everyday activities, such as driving, reading, or watching TV. You and your eye care professional can make this decision together. 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. You do not have to rush into surgery.

Sometimes a cataract should be removed even if it does not cause problems with your vision. For example, a cataract should be removed if it prevents examination or treatment of another eye problem, such as age-related macular degeneration or diabetic retinopathy. If your eye care professional finds a cataract, you may not need cataract surgery for several years. In fact, you might never need cataract surgery. By having your vision tested regularly, you and your eye care professional can discuss if and when you might need treatment.

If you choose surgery, your eye care professional may refer you to a specialist to remove the cataract.

If you have cataracts in both eyes that require surgery, the surgery will be performed on each eye at separate times, usually four to eight weeks apart.

Many people who need cataract surgery also have other eye conditions, such as age-related macular degeneration or glaucoma. If you have other eye conditions in addition to cataract, talk with your doctor. Learn about the risks, benefits, alternatives, and expected results of cataract surgery.

What are the different types of cataract surgery?

There are two types of cataract surgery. Your doctor can explain the differences and help determine which is better for you:

  1. Phacoemulsification, or phaco. A small incision is made on the side of the cornea, the clear, dome-shaped surface that covers the front of the eye. Your doctor inserts a tiny probe into the eye. This device emits ultrasound waves that soften and break up the lens so that it can be removed by suction. Most cataract surgery today is done by phacoemulsification, also called “small incision cataract surgery.”
  2. Extracapsular surgery. Your doctor makes a longer incision on the side of the cornea and removes the cloudy core of the lens in one piece. The rest of the lens is removed by suction.

After the natural lens has been removed, it often is replaced by an artificial lens, called an intraocular lens (IOL). An IOL is a clear, plastic lens that requires no care and becomes a permanent part of your eye. Light is focused clearly by the IOL onto the retina, improving your vision. You will not feel or see the new lens.

Some people cannot have an IOL. They may have another eye disease or have problems during surgery. For these patients, a soft contact lens, or glasses that provide high magnification, may be suggested.

What are the risks of cataract surgery?

As with any surgery, cataract surgery poses risks, such as infection and bleeding. Before cataract surgery, your doctor may ask you to temporarily stop taking certain medications that increase the risk of bleeding during surgery. After surgery, you must keep your eye clean, wash your hands before touching your eye, and use the prescribed medications to help minimize the risk of infection. Serious infection can result in loss of vision.

Cataract surgery slightly increases your risk of retinal detachment. Other eye disorders, such as high myopia (nearsightedness), can further increase your risk of retinal detachment after cataract surgery. One sign of a retinal detachment is a sudden increase in flashes or floaters. Floaters are little “cobwebs” or specks that seem to float about in your field of vision. If you notice a sudden increase in floaters or flashes, see an eye care professional immediately. A retinal detachment is a medical emergency. If necessary, go to an emergency service or hospital. Your eye must be examined by an eye surgeon as soon as possible. A retinal detachment causes no pain. Early treatment for retinal detachment often can prevent permanent loss of vision. The sooner you get treatment, the more likely you will regain good vision. Even if you are treated promptly, some vision may be lost.

Talk to your eye care professional about these risks. Make sure cataract surgery is right for you.

Is cataract surgery effective?

Cataract removal is one of the most common operations performed in the United States. It also is one of the safest and most effective types of surgery. In about 90 percent of cases, people who have cataract surgery have better vision afterward.

What happens before surgery?

A week or two before surgery, your doctor will do some tests. These tests may include measuring the curve of the cornea and the size and shape of your eye. This information helps your doctor choose the right type of IOL.

You may be asked not to eat or drink anything 12 hours before your surgery.

What happens during surgery?

At the hospital or eye clinic, drops will be put into your eye to dilate the pupil. The area around your eye will be washed and cleansed.

The operation usually lasts less than one hour and is almost painless. Many people choose to stay awake during surgery. Others may need to be put to sleep for a short time.

If you are awake, you will have an anesthetic to numb the nerves in and around your eye.

After the operation, a patch may be placed over your eye. You will rest for a while. Your medical team will watch for any problems, such as bleeding. Most people who have cataract surgery can go home the same day. You will need someone to drive you home.

What happens after surgery?

Itching and mild discomfort are normal after cataract surgery. Some fluid discharge is also common. Your eye may be sensitive to light and touch. If you have discomfort, your doctor can suggest treatment. After one or two days, moderate discomfort should disappear.

For a few days after surgery, your doctor may ask you to use eyedrops to help healing and decrease the risk of infection. Ask your doctor about how to use your eyedrops, how often to use them, and what effects they can have. You will need to wear an eye shield or eyeglasses to help protect your eye. Avoid rubbing or pressing on your eye.

When you are home, try not to bend from the waist to pick up objects on the floor. Do not lift any heavy objects. You can walk, climb stairs, and do light household chores.

In most cases, healing will be complete within eight weeks. Your doctor will schedule exams to check on your progress.

Can problems develop after surgery?

Problems after surgery are rare, but they can occur. These problems can include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, double vision, and high or low eye pressure. With prompt medical attention, these problems can usually be treated successfully.

Sometimes the eye tissue that encloses the IOL becomes cloudy and may blur your vision. This condition is called an after-cataract. An after-cataract can develop months or years after cataract surgery.

An after-cataract is treated with a laser. Your doctor uses a laser to make a tiny hole in the eye tissue behind the lens to let light pass through. This outpatient procedure is called a YAG laser capsulotomy. It is painless and rarely results in increased eye pressure or other eye problems. As a precaution, your doctor may give you eyedrops to lower your eye pressure before or after the procedure.

When will my vision be normal again?

You can return quickly to many everyday activities, but your vision may be blurry. The healing eye needs time to adjust so that it can focus properly with the other eye, especially if the other eye has a cataract. Ask your doctor when you can resume driving.

If you received an IOL, you may notice that colors are very bright. The IOL is clear, unlike your natural lens that may have had a yellowish/brownish tint. Within a few months after receiving an IOL, you will become used to improved color vision. Also, when your eye heals, you may need new glasses or contact lenses.

What can I do if I already have lost some vision from cataract?

If you have lost some sight from cataract or cataract surgery, ask your eye care professional about low vision services and devices that may help you make the most of your remaining vision. Ask for a referral to a specialist in low vision. Many community organizations and agencies offer information about low vision counseling, training, and other special services for people with visual impairments. A nearby school of medicine or optometry may provide low vision services.

Current Research

What research is being done?

The National Eye Institute is conducting and supporting a number of studies focusing on factors associated with the development of age-related cataract. These studies include:

  • The effect of sunlight exposure, which may be associated with an increased risk of cataract.
  • Vitamin supplements, which have shown varying results in delaying the progression of cataract.
  • Genetic studies, which show promise for better understanding cataract development.

This online resource guide provides information about cataracts. It answers questions about causes and symptoms, and discusses diagnosis and types of treatment. It was adapted from Don’t Lose Sight of Cataract (NIH Publication No. 94-3463) and Cataract: What You Should Know (NIH Publication No. 03-201).

Last Reviewed:
September 2009

Courtesy: National Eye Institute, National Institutes of Health (NEI/NIH)

The National Eye Institute (NEI) is part of the National Institutes of Health (NIH) and is the Federal government’s lead agency for vision research that leads to sight-saving treatments and plays a key role in reducing visual impairment and blindness.

May is Ultraviolet Awareness Month

Exposure to UV rays can burn delicate eye tissue and raise the risk of developing cataracts and eye cancer. Sunglasses help.

woman wearing hat and sunglasses

Proper sunglasses and a wide-brimmed hat reduce exposure to UV rays.

Ultraviolet Awareness

The sun releases energy (radiation) in many forms. The sunlight we see is one form. The heat we feel from the sun is another. Ultraviolet (UV) rays, a third type, are also invisible to the eye. UV rays cause sunburn. They can also damage your eyes and hurt your vision.

There are two types of UV rays: UV-A and UV-B. Over time, the effects of UV rays may help cause a number of eye problems.

UV-A can hurt your central vision. It can damage the macula, a part of the retina at the back of your eye.

UV-BThe front part of your eye (the cornea and the lens) absorbs most UV-B rays, but these rays may cause even more damage to your eyes than UV-A rays.

What Eye Problems Can UV Rays Cause?

Macular Degeneration

UV rays may lead to macular degeneration, a leading cause of vision loss for older Americans.

Cataract

UV rays, especially UV-B rays, may also cause some kinds of cataracts. A cataract is a clouding of the eye’s natural lens, the part of the eye that focuses the light we see.

Pterygium

Another UV-related problem is a growth called pterygium. This growth begins on the white of the eye and may involve the cornea. Eventually, the growth may block vision. It is more common in people who work outside in the sun and wind.

Skin Cancer

Skin cancer around the eyelids is also linked to prolonged UV exposure.

Corneal Sunburn

Corneal sunburn, called photokeratitis, is the result of high short-term exposure to UV-B rays. Long hours at the beach or skiing without proper eye protection can cause this problem. It can be very painful and may cause temporary vision loss.

You can protect your eyes from UV rays in two important ways:

  1. Know the dangers of UV rays.
  2. Wear proper eye protection and hats that block UV rays.

UV rays can come from many directions. They radiate directly from the sun, but they are also reflected from the ground, from water, snow, sand and other bright surfaces.

Wear Sunglasses and a Brimmed Hat

Use eyewear that absorbs UV rays and wear a brimmed hat or cap.

A wide-brimmed hat or cap will block about half of UV rays. A brimmed hat or cap can also limit UV rays that hit the eyes from above or around glasses.

Eyewear that absorbs UV rays gives you the most protection. All types of eyewear, including prescription and non-prescription glasses, contact lenses and lens implants, should absorb UV-A and UV-B rays. For UV protection in everyday eyewear, there are several options like UV-blocking lens materials, coatings and photochromic lenses. UV protection does not cost a lot of money and does not get in the way of seeing clearly.

2018 Person of Vision: Judith Lisi

Judith Lisi

Judith Lisi

Judith Lisi, President and Chief Executive Officer, Straz Center for the Performing Arts, was honored as our 2018 Person of Vision on February 19, 2018 at the Tampa Airport Marriott.

Judith Lisi joined the Straz Center in 1992. Through her leadership, the Straz Center has significantly expanded its programming, established financial stability, retired an accumulated debt, and has met the goals of three five-year, long-range plans. Lisi’s arts management philosophy includes a belief in, and a commitment to, the community and to ensuring outreach, accessibility, and audience development for the entire community through multicultural and educational programming.

Lisi has directed more than 40 productions and has written six plays. She holds a Master’s Degree in theater and communication arts from St. Louis University and has done doctoral work in theater at the University of Minnesota. She studied opera at the Juilliard School of Music and with the Metropolitan Opera. Previously, as Executive Director of the prestigious Shubert Performing Arts Center in New Haven, Connecticut, the Shubert enjoyed artistic and financial success.

In May 2002, the League of American Theatres and Producers honored Lisi with the Samuel J. L’ Hommedieu Presenter of the Year Award for “bringing the magic of live theater to thousands of area residents through a variety of audience development and education programs.”

In January 2008, Lisi received the prestigious Patrick Hayes Award for Lifetime Achievement from ISPA, the International Society for the Performing Arts.

Preserve Vision Florida hosts the annual dinner to honor a person of vision who has had a profound impact on the region or state of Florida through true community leadership and vision.

Previous honorees have included Joseph W. Lopano, Chief Executive Officer of Tampa International Airport (2017); Tampa Maybor Bob Buckhorn (2016); Jeff and Penny Vinik (2015); Betty Castor and US Representative Kathy Castor (2014); and many other luminaries.