Identifying and preventing cataracts, part 1

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By Jean E. Keamy, M.D.

Many of you may wonder what a cataract is. Is family history important to the development of a cataract? Can you prevent cataracts ? Will cataracts cause blindness? How are cataracts fixed?

Some diseases are associated with congenital cataracts, present at birth. For the majority, cataracts are a natural aging process of the eye. Inside the eye, there is a lens behind the iris. It functions much like the lens in a camera to help focus the image on the retina or film. When we are children, the lens is completely clear.

By middle age, the lens turns slightly yellow. By elder years, the lens can turn shades of dark yellow or even brown or white. This makes the lens cloudy. The cloudy lens is called a cataract.

The cataract can be so slight that it does not cause any decrease in vision. Eventually, the cataract can become so cloudy that the vision is affected. Usually the first sign of a cataract is glare and halos when driving at night. Other symptoms include decreased vision in bright sunlight, difficulty reading, loss of fine details and an inability to see vivid colors. Eventually the vision will decline as the lens become more and more opaque. When the cataract is so dense that the vision cannot be corrected with glasses or the cataract has made daily tasks impossible, cataract surgery is recommended.

There are several kinds of cataracts. Some children develop or are born with cataracts. These are called congenital cataracts. The most common kind of cataract is a nuclear sclerotic cataract. This results from the aging of the lens. Typically, it looks like a yellow or brown marble. Another type of cataract is a cortical cataract. This looks like white icicles. Sometimes cortical cataracts can be present peripherally and not affect the vision for a long time. When the icicle grows through the center of the lens, vision can decline dramatically.

One of the other most common cataracts is a posterior sub-capsular cataract. This type of cataract forms centrally on the back surface of the lens. Often it will develop quickly. Posterior sub-capsular cataracts usually cause significant halos and glare at night and in bright sunlight. The last type of cataract is called a mature cataract. A mature cataract is a very dense opaque lens that causes such a decrease in vision that it results in blindness.

There are no drugs to prevent cataracts. A healthy lifestyle is the best prevention. Eat well, minimize sugars and include a variety of vegetables and fruits. Increase your diet with antioxidants through food and vitamins. Do not smoke. Wear sunglasses whenever outside in the daytime. Once you have visually significant cataracts, the only way to get rid of them is through surgery. Stay tuned for Cataracts Part 2 in next month’s issue.

Dr. Jean Keamy is a board certified ophthalmologist specializing in cataract surgery, refractive surgery, eyelid surgery and diseases of the eye. She owns Keamy Eye & Laser Centre on 24 Lyman St. in Westborough and can be reached at 508-836-8733. Learn more at www.seemedrkeamy.com.