Cataracts are common in older adults, affecting almost 50% of the population aged 80 and over. Although cataracts are one of the leading causes of blindness worldwide, accounting for more than 40% of cases, they are also one of the most treatable serious eye conditions.
A cataract is a clouding of the normally clear lens which lies behind the colored iris. The lens focuses images on the retina, which relays them to the brain. The focused image projected onto the retina is sharp and clear in a normally clear lens. When the lens develops cataracts, the cloudy change in the lens reduces vision and causes the image projected onto the retina to be blurry.
Cataract formation is a normal part of the aging process and may become visually significant in older adults. In rare cases, children born with a defect in the eye or whose mother had German measles while they were pregnant, may have congenital cataracts.
Several factors may increase the risk of developing a visually significant cataract. Such risk factors include:
- Exposure to intense heat, or UV rays from the sun over a long period
- Certain health conditions that affect the eyes, such as diabetes
- Inflammation in the eyes from injury or illness
- Long-term use of steroids
- Eye disease
Visual loss due to cataracts may progress so gradually that a patient may not be aware of it until it becomes advanced. Regular vision care exams are the best way to identify the formation of cataracts before significant vision loss occurs. If any of the following apply, a thorough eye examination is indicated:
- Blurred or double vision
- Seeing a “film” over one’s vision
- Feeling that lights are always too dim
- Having trouble reading or doing work up close
- Difficulty seeing in bright light
- Frequent changes in eyeglass prescription that don’t seem to help
- A milky or yellowish spot on the eye
There are four main types of cataracts:
- Age-related cataracts account for 95% of cases. They typically show up after age 40, and gradually worsen over time.
- Congenital cataracts are present at birth. They may be inherited or caused by problems during the pregnancy.
- Traumatic cataracts are caused by lens damage and can occur due to a hard blow, cut, puncture, intense heat, or chemical burn.
- Secondary cataracts are adjacent to a cause or treatment. Causes include medicines, eye disease, infection, or disease (like diabetes).
If you develop cataracts in one eye, there is an increased likelihood you will develop them in both eyes. However, the rate of progression may vary widely. Your eye care professional can examine your eyes to determine if the basis for your blurred vision is a cataract or another cause, such as glaucoma, macular degeneration, or diabetic retinopathy
In the U.S., more than 25 million Americans are estimated to have cataracts, and thanks to the aging of the population in America, that number is projected to increase by 50% to 38.5 million by 2032.
The Centers for Disease Control and Prevention considers blindness or vision problems to be among the top 10 disabilities among adults aged 18 years and older. Loss of vision leads to loss of independence, social deprivation and increased morbidity often associated with medication errors or deficient nutrition.
Cataracts are the leading cause of blindness and the second cause of moderate and severe vision impairment (MSVI), accounting for between 33% and 48% of global visual impairment. Nearly 11 million people suffered from cataract-related blindness in 2010, accounting for one-third of blindness cases worldwide, and it’s estimated this number will increase to 40 million people by 2025.
Vision loss and blindness contribute to a social and economic burden, with a total annual economic impact in the U.S. of approximately $51.4 billion. The overall relative reduction in employment by people with vision loss is 30.2%, and the potential productivity losses due to MSVI and blindness are more than $400 billion in purchasing power parity.
The most effective treatment for cataracts is surgery. Every year, more than 2 million cataract surgeries are performed in the U.S. alone, with no complications of any kind in over 95% of cases.
Cataract surgery involves removing the clouded lens and replacing it, with an intraocular lens (IOL) whose precise power is individually determined by your vision needs. The IOL is implanted where the original lens was located. In most circumstances, the eye heals quickly, and improved vision returns within a few days.
Surgery is typically performed on an outpatient basis and is commonly completed in less than an hour. Patients are typically given eyedrops to prevent infection and reduce inflammation. Many patients find they no longer need glasses for distance and may only need a standard prescription for reading. Newer technologies in implant design may allow patients to be free of any spectacle correction.
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