Understanding cataracts

Vision fuzzy? Feel like your glasses always need cleaning? If you're over 40, you may be among the 1.2 million Canadians with cataracts. And now, thanks to new surgical procedures, it’s likely your eyesight could be as good as new.

Hanging suspended in a transparent capsule, just behind the pupil of your eye, is a clear lens. Its function is to make your vision sharp. But just about the time you cross the midpoint of life and head for your 60s and 70s, the lens often starts to become unreliable. Its protein fibres gradually begin to clump together, like sugar congealing in a container of maple syrup, causing a cloudiness that’s known as a cataract.

Ordinarily, when you look at something, light rays reflected from the object enters your eye through the cornea and the lens. The lens then focusses the light onto the retina at the back of your eye, which sends the image to your brain. When a cataract develops, the light rays are no longer precisely focussed but instead scatter before reaching the retina.

Generally a cataract forms on the lens of both eyes but not necessarily at the same time. And in its earliest stages it may not cause a vision problem. But, eventually, as the protein fibres begin to clump further and then break down, images dim, colours fade and distinctions between light and dark turn fuzzy. Double vision may also occur.

The speed and extent of your vision impairment depends not only on the size and density of the cataract but also on what type it is. There are several variations, and more than one type can be present in the same eye. Although cataracts can form at any age, most occur in later life.

A number of factors increase that risk even more, including smoking, lots of exposure to bright sunlight and long-term oral corticosteroid use (especially at high doses). And you are more likely to develop cataracts if you have a related health problem, such as glau­coma, diabetes, high blood pressure (hypertension) or an immune-system disease like rheumatoid arthritis. Genetics, too, can play a role. By far the most dominant risk factor, however, is aging.

• A specialized eye examination by an ophthalmologist to determine where the cataracts are located, if they're in one or both eyes and how far the condition has advanced.
• An assessment of your vision impairment to find out whether you need surgery soon, or just a follow-up appointment.
• Discussion with your doctor about possible procedures for eye surgery and how much time you should reserve for recovery.

1. If you smoke, give it up. Smoking doesn't cause cataracts, but research shows that this eye condition develops much more rapidly and more frequently in those who do smoke. In fact, some of the damage done by smoking may be reversed if you stop right away.
2. Shield your eyes from bright sunlight. A mild cataract condition is likely to get worse if your eyes are exposed to ultraviolet (UV) rays.
3. Ask someone to help you after surgery. Although the outpatient cataract procedure is simple and painless, you will need someone to drive you home from the clinic or hospital afterward. For the next few days, while your eyes are adjusting, you will continue to need a person to drive and help with household chores, especially those that require exertion.
4. If a second eye needs surgery, don't wait too long. Discuss your particular situation with your doctor.