Paging Dr. Frischer: Cataracts

Has your vision has been gradually declining? Do your surroundings seem darker than usual? You could be suffering from cataracts. Worldwide, cataracts are the leading cause of vision loss.
 
A cataract is a clouding of the lens in the eye, and most are related to aging. They can occur in either one or both eyes, but do not spread from one eye to another. Cataracts affect more than 22 million Americans age 40 and older. By age 80, more than half of all Americans will have cataracts (or will have had cataract surgery), There are more cases of cataracts worldwide than there are of glaucoma, macular degeneration, and diabetic retinopathy combined.
 
To understand more, let’s review some anatomy. The lens of the eye focuses light, or an image, onto 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.
 
Why does a clear lens become cloudy? The lens is made of mostly water and protein. As we age, some of the protein may clump together and gradually cloud more and more of the lens. In addition, the lens may slowly color with age, with vision gradually acquiring a brownish shade.
 
How can you tell if you might have a cataract? Be aware of cloudy or blurry vision, faded colors, glare from headlights or lamps, halos around lights, sunlight that appears to be too bright, poor night vision, double vision or multiple images in one eye, and frequent changes in prescription for glasses or contact lenses. Your optometrist or ophthalmologist can make a diagnosis.
 
Treatment depends on the stage of the disease. In the early stages, new glasses, brighter light, anti-glare sunglasses, and magnifying lenses will help. When these measures are no longer effective, and the vision loss interferes with everyday activities, surgery can remove the cloudy lens and replace it with an artificial one. Cataract surgery is one of the most common operations, and is quite safe and effective. Because an artificial lens replaces the old cloudy lens, once the surgery has been done, the cataract cannot return.
 
Even though cataracts may start earlier, vision problems are often not noticed until age 60 and older. Researchers have not determined exactly why cataracts tend to form with age, but risk factors include:

■ Ultraviolet radiation (from sunlight and other sources)

■Diabetes

■Hypertension

■Obesity

■Smoking

■Long-term use of corticosteroid medications

■Statin medicines (used to reduce cholesterol)

■Previous eye injury, inflammation, or eye surgery

■Hormone replacement therapy

■Significant alcohol consumption

■Extreme nearsightedness

■Family history

 
You will notice that some of these potential risk factors can be prevented with lifestyle changes (including smoking!) and others are more problematic. A number of controversial studies suggest that certain nutrients and nutritional supplements may reduce the risk. Vitamin E and the carotenioids lutein and zeaxanthin may be effective. These can be found in sunflower seeds, almonds, spinach, kale, and other green leafy vegetables, as well as in supplements.

Researchers also believe that good overall nutrition can help reduce the risk of age-related cataracts. I would certainly recommend eating green leafy vegetables, fruit, and other foods with antioxidants, even with an unproven link to cataract prevention.
 
If you have observed that your vision is declining, becoming darker, or that you see halos at nighttime, the good news is that your problem may very well be able to be fixed with a simple surgery. I encourage you to see your doctor.