Signs Of Cataract — When Is It Time For Cataract Surgery?

A common question often asked by older patients attending an eyecare appointment is how to tell they’re developing cataracts. Because cataracts are typically considered a normal part of ageing, if you have any close friends or family over the age of 60, it’s most likely that you know someone developing cataracts or who has already gone through cataract surgery. Keep reading to find out what you should know about the signs of a cataract.

What is a Cataract?

A cataract refers to any haze or opacity of the crystalline lens inside the eye. A young, healthy lens is clear and transparent, allowing light to pass through freely to form sharp vision. There are many underlying causes of cataracts, including some systemic diseases, eye injuries, and certain medications. However, the most common cause of a cataract is older age. 

As we get older, age-related changes to the body result in the lens fibres losing their transparent arrangement. The lens becomes cloudy, hazy, or can develop discrete dense opacities. It’s the location and density of the opacity or haze that can affect what signs of the cataract you might notice.

Signs of a Cataract

In the early stages of developing cataracts, many people are entirely unaware of any changes to their sight. As the signs of a cataract tend to progress quite slowly, it’s often not until a person undergoes cataract surgery that they realise how much their sight had been impacted. 

Here are some of the signs of a cataract that might alert you of needing cataract surgery in the next several years. 

Deteriorating clarity of sight 

As the fibres of the crystalline lens slowly lose their optically transparent arrangement, incoming light is unable to be transmitted as easily through the eye. The result is a decline in the sharpness, or acuity, of your vision. Different people may describe the quality of their vision differently. Some might describe it as blurry, while others may be more likely to use the words hazy or foggy, or filmy. Some people may feel like they’re looking through a dirty window or smudged glasses that can’t be cleaned. In some cases, updating your glasses or contact lenses can help to restore sharp sight, but eventually, vision through a cataract typically reaches a point that can’t be improved with glasses. At this point, many people consider cataract surgery. 

Frequently changing prescriptions

It’s not unusual for a spectacle or contact lens script to shift slightly every few years or so. However, developing cataracts can cause your script to change more rapidly than normal, and to a larger degree. Some people may find their new glasses or contact lens script becoming blurry even within 6 months. A shift to a prescription due to cataracts can cause either more long-sightedness (hyperopia) or short-sightedness (myopia). It can even affect your astigmatism. As mentioned earlier, updating your glasses or contacts may be sufficient to improve your sight to a level you’re happy with. However, if your prescription is altering significantly every 12 months, it can become quite costly to keep up with these changes. It may be more worthwhile to undergo cataract surgery if this is the case. 

Increasing difficulty with low lighting conditions

The effect of cataracts on your contrast sensitivity is often what people notice early on. However, not many are aware that these changes are a result of developing cataracts. Contrast sensitivity refers to your ability to pick out details of an object against a similarly shaded background. For example, reading grey text against a black background. As your cataracts progress, you may find that your ability to read print in a dimly lit environment such as a restaurant is not as good as it used to be. Another example is feeling less confident when driving at night or in low visibility road conditions such as heavy rain. 

Increasing discomfort with glare

Glare affects a lot of people, and it’s not always due to cataracts. However, certain types of cataracts, particularly dense opacities, can scatter light entering the eye, which we perceive as glare. Glare might be just slightly uncomfortable, or it can be debilitating. You might find oncoming car headlights when driving at night time to be particularly bright and uncomfortable. Backlit digital devices such as tablets, phones, and computer screens may also cause some discomfort if the screen brightness is too high. While adjusting the brightness of your digital devices is easy, it’s not as simple when it comes to street lights and car headlights. If glare from cataracts is a particular concern, cataract surgery is the most definitive way of addressing this. 

Shifts in colour perception

This is possibly the most difficult sign of a cataract to notice unless you’re particularly attuned to your colour vision. One type of age-related cataract known as nuclear sclerosis causes a brown-yellow haze in the centre (nucleus) of the lens. This discolouration affects which wavelengths of light can pass through the lens, which can alter your perception of colour. Many people coming out of cataract surgery often comment on how vibrant colours appear after the cataracts are removed. 

It’s important to note that it’s extremely rare for a cataract to cause any pain, redness, or inflammation of the eye. This only occurs if the cataract is so hyper-advanced that it ruptures and causes inflammation. 

Is It Time for Cataract Surgery?

In discussion with your eye care professional, you yourself are best placed to decide whether it’s time for cataract surgery. In most cases, this is based on how much your deteriorating vision is impacting your daily activities, like reading and driving.

Call us on (03) 9070 5753 today.

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

References

Cataracts.
https://www.healthdirect.gov.au/cataracts#symptoms

Cataracts.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts

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