Cataracts are a common eye condition that affect virtually everyone if you live long enough. Typically it’s in our 60s and 70s when we notice more glare, blur, difficulty reading road signs, but often times people don’t even realize that their vision is declining. I’ve often had patients who have the cataracts removed only to discover that their furnishings in their house are a different color than what they thought because the cataract removal changes and brightens color perception. Cataracts are one of the leading causes of blindness worldwide, but with surgery, cataracts are completely curable. In this blog post, we’ll discuss the age at which cataracts typically start to develop, as well as risk factors and treatment options.

What are cataracts?

Cataracts are a (usually gradual) clouding of the natural lens in the eye which can cause blurry or hazy vision, glare around lights, and difficulty seeing at night, particularly while driving. The lens of our eye is responsible for focusing light onto the retina, much like a camera. When the natural lens becomes cloudy, it can scatter and filter the light, which causes the above visual symptoms.

Cataracts are usually a result of the natural aging process, but they can also be caused by other factors such as trauma, certain medications (steroids specifically), and radiation, as well as systemic health factors such as diabetes, obesity, smoking, and ultraviolet light. Cataracts-most of the time-develop in both eyes fairly symmetrically, and they can progress slowly over time or more quickly depending on the underlying cause and other factors.

What age do cataracts start?

Cataracts can start to develop at any age-even in utero. Some babies are born with congenital cataracts, which can be extremely difficult to treat. Fortunately, they are most common in older adults. According to the American Academy of Ophthalmology, more than half of all Americans over the age of 80 have cataracts or have had cataract surgery.

However, it is not uncommon for cataracts to start to develop in middle age. In fact, some people may develop cataracts in their 40s or 50s. This is known as age-related cataracts and is caused by the natural aging process of the eye. I remember a high school classmate I saw in the clinic who had fairly dense cataracts at age 39. As we get older, the proteins in the lens of the eye begins to change, which can cause loss of transparency in the lens. I think an analogy is appropriate here: imagine a start of a plant in clear tap water in a glass on the windowsill. The water will start clear and then gradually turns a yellow/green color and gets cloudier. This is what the lens of our eye looks like over many years. First it turns slightly yellow/green, then it gets cloudier and cloudier.

Other types of cataracts can also develop at different ages. Congenital cataracts are present at birth or develop in early childhood, and they can be caused by genetic factors or infections during pregnancy. Traumatic cataracts can develop after an injury to the eye. Secondary cataracts can develop as a complication of certain diseases or medications. The most common association with medications is steroids. People can develop what’s called a posterior subcapsular cataract with systemic steroid use, using eyedrops containing steroids, or even using nasal spray such as Flonase. I’ve seen that twice in my career, so far.

What are the risk factors for cataracts?

There are several risk factors that can increase the likelihood of developing cataracts, including:

• Age: As mentioned earlier, cataracts are most common in older adults.
• Uncontrolled Diabetes: People with uncontrolled diabetes are more likely to develop cataracts, as high blood sugar levels can cause changes in the lens of the eye.
• Smoking: Smoking is a risk factor for many health conditions, including cataracts.
• Exposure to sunlight and ultraviolet (UV) radiation: Prolonged exposure to sunlight and UV radiation can increase the risk of cataracts. This is why the area around the equator is associated with a very high incidence of cataract formation at a young age.
• Certain medications: Some medications, such as corticosteroids, can increase the risk of cataracts, whether they are systemic steroids, eyedrops, or even nasal spray containing steroids such as Flonase.
• Eye injuries: Trauma to the eye can increase the risk of developing cataracts.

If you have any of these risk factors, it’s important to be vigilant about your eye health and to see an eye doctor regularly for checkups.

What are the symptoms of cataracts?

Cataracts can cause a variety of symptoms, including:

• Blurry or hazy vision
• Sensitivity to light
• Difficulty seeing at night
• Double vision in one eye
• Seeing halos around lights
• Fading or yellowing of colors
• Needing brighter light for reading or other activities

It’s important to note that some people with early-stage cataracts may not experience any symptoms at all. This is why regular eye exams are important for detecting cataracts and other eye conditions.

How are cataracts treated?

The only way to cure cataracts is through surgery, which involves removing the cloudy lens and replacing it with an artificial lens. Cataract surgery is one of the most common and successful surgeries performed in the United States, with a success rate of over 98%. During the surgery, the cloudy lens is removed and a small incision is made in the eye. An artificial lens, also called an intraocular lens (IOL), is then implanted to replace the natural lens.

Cataract surgery in the United States is performed on an outpatient basis and is a safe and straightforward procedure. Most people are able to resume normal activities within a day after surgery, although it may take a few weeks for vision to fully stabilize.

In some cases, cataract surgery may not be necessary if the cataracts are not causing significant vision problems. In these cases, your eye doctor may recommend using prescription eyeglasses or contact lenses to correct vision problems caused by cataracts.

Preventing cataracts

While there is no surefire way to prevent cataracts from developing, there are several steps you can take to reduce your risk of developing them:

1. Protect your eyes from UV radiation: Wear sunglasses and a hat when spending time outdoors to protect your eyes from the sun’s harmful UV rays.
2. Quit smoking: If you smoke, quitting can reduce your risk of developing cataracts as well as other health problems.
3. Eat a healthy diet: Eating a diet rich in fruits and vegetables, particularly those high in vitamin C and antioxidants, may help prevent cataracts from developing.
4. Manage other health conditions: If you have diabetes or other health conditions that can increase your risk of cataracts, it’s important to manage those conditions to reduce your risk.
5. Get regular eye exams: Seeing an eye doctor regularly for checkups can help detect cataracts and other eye conditions early on, when they are easier to treat.

Conclusion

Cataracts are a common eye condition that can cause significant vision problems if left untreated. While cataracts are most common in older adults, they can develop at any age and can be caused by a variety of factors. Regular eye exams and taking steps to reduce your risk factors can help prevent cataracts from developing, and cataract surgery is a safe and effective treatment option if cataracts do develop. If you are experiencing any vision problems or are at risk of developing cataracts, be sure to see an eye doctor for a comprehensive eye exam.