What is cataract vision like?
What are cataracts?
As people enter their advanced years, most will develop cataracts where the natural lens in the eye becomes cloudy or opaque, causing blurred and decreased field of vision. For some, contrast and colour perception may be affected in the early stages. Our eye works very much like a camera. When light enters the front of the eye, it passes through our natural lens which helps focus the light on the back of our eye on a tissue called the retina. The retina acts as a screen to capture the image, which is then sent to the brain for interpretation. Very much like a camera lens, a clear natural lens will give you clear and sharp vision. Likewise, a cloudy lens will give your cloudy vision.
Why does one develop cataracts?
The eye’s natural lens is made mostly of proteins and water. These proteins are arranged in a specific manner which keep the lens clear and allow light to pass through it. However, as the lens ages, some of the proteins may clump together, causing it to turn cloudy. Most cataracts develop and progress slowly, so they do not immediately affect your vision in the initial stages. Over time though, it will grow larger, clouding more of the lens, and eventually affects the vision.
Besides old age, other risk factors for cataracts include:
- Ultraviolet radiation
- Prolonged use of corticosteroid medication
- Statin medicines used to reduce cholesterol
- Previous eye injury or inflammation
- Previous eye surgery
- Hormone replacement therapy
- Significant alcohol consumption
- High myopia
- Family history
Cataract is the most common cause of vision loss in people over age 40 and is also the principal cause of blindness in the world. However, vision loss is reversible when the natural lens is replaced with an artificial one with cataract surgery.
How will I know I have cataracts?
In the early stages of cataracts, one may not notice a significant change in their vision as this condition is a slow-progressing condition. You may however feel that stronger lighting and glasses will help you see better. As your natural lens gets more and more cloudy, it is like looking through a frosted or fogged-up window. Day-to-day tasks such as reading, writing and viewing distant objects like road signs may prove challenging. Cloudy vision can pose danger especially for older folks who may miss a step when climbing stairs or not being able to see oncoming traffic when crossing the road.
Some other symptoms of cataracts include:
- Blurry vision
- Seeing double or shadow of an image
- Being extra sensitive to light
- Having trouble seeing well at night, or needing more light when you read
- Seeing bright colours as faded or yellowed
You do not have to wait till you have symptoms of cataracts to have your eyes examined. It is recommended to get a yearly eye examination by an ophthalmologist for those about 45 years old, akin to how one would visit the dentist yearly or more frequently to maintain one’s oral health. During an eye examination, eyedrops will be instilled on the eyes to dilate the pupils for the ophthalmologist to check the back of the eyes for cataracts as well as to rule out other potential eye diseases that can cause blurry vision.
What can I do if I have cataracts?
When cataract has little impact on your vision, you may choose to follow up with your ophthalmologist at regular intervals to monitor its progression. However, if impaired vision interferes with your daily activities and your quality of life, you may consider going for cataract surgery, which is the only effective way to remove cataract. Cataract surgery is the single most performed eye surgery and it is a generally considered safe and low-risk procedure.
In the past, we used to wait till the cataract is ‘ripe” or ‘mature’ before considering cataract surgery as it was performed through a large incision, which resulted in longer healing time and poorer predictability of the surgical outcome. However, with technological advancements, cataract surgery today is performed through a keyhole incision, either manually by the eye surgeon or with a laser. This keyhole incision has resulted in lower rates of complication, faster recovery time, better visual prognosis and more predicted surgical outcomes. Also, very ‘ripe’ or ‘mature’ cataracts are thick which render them unsuitable for the keyhole incision method. Thus, more and more people are choosing to have their cataract surgery at an earlier age.
Choosing to have a cataract surgery earlier in itself has some other benefits which include being generally healthier than one might be when older and being able to enjoy more years of good vision during active years. Cataract surgery is a one-time surgery as the cataract does not regrow once removed. Currently, there are also more lens options than in the past. Some of these artificial lenses, known as intraocular lenses, can potentially eliminate the need to use glasses for both near and far distances, another reason why people are choosing to consider cataract surgery at a younger age.