LEARN MORE ABOUT CATARACT

Cataracts

By Judith Lee and Gretchyn Bailey;
reviewed by Vance Thompson, MD

A cataract is a clouding of the eye's natural lens, which lies behind the iris and the pupil. The lens works much like a camera lens, focusing light onto the retina at the back of the eye. The lens also 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.

Researchers are gaining additional insights about what causes these specific types of proteins (crystallins) to cluster in abnormal ways to cause lens cloudiness and cataracts. One recent finding suggests that fragmented versions of these proteins bind with normal proteins, thus disrupting normal function.


Hazy or blurred vision may indicate a cataract.
Cataracts are classified as one of three types:

A nuclear cataract is most commonly seen as it forms. This cataract forms in the nucleus, the center of the lens, and is due to natural aging changes.

A cortical cataract, which forms in the lens cortex, gradually extends its spokes from the outside of the lens to the center. Many diabetics develop cortical cataracts.

A subcapsular cataract begins at the back of the lens. People with diabetes, high farsightedness, retinitis pigmentosa or those taking high doses of steroids may develop a subcapsular cataract.
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. 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.


Left: A cataract is a clouding of the eye's natural lens. See animation.

Right: Cataracts affect vision by scattering incoming light. See animation.

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. Meanwhile, 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?
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 eyecare practitioners recommend wearing sunglasses and a wide-brimmed hat to lessen 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.