With cataract surgery being the top most commonly performed eye surgery in the world, it’s not unexpected that you would be familiar with the age-related condition that is cataracts. However, for many people, the finer details of common cataract symptoms and how they’re diagnosed can be a little less well-known. So, what does a cataract look like?
What Does a Cataract Look Like to You: Symptoms of a Cataract
Cataracts refer to opacities or haziness that form in the crystalline lens behind the coloured iris. Usually, this lens is transparent, allowing the free transmission of light into the eye. So, as this lens becomes hazier or cloudier with progressing age, it naturally will interfere with your sight.
It’s not typically possible to see your own cataracts in a mirror as they’re hidden behind the iris. However, if viewing someone else with a cataract from the right angle, you may notice a whitish glint in their pupil. This is a sign known as leukocoria. When it comes to yourself, suspecting you’re developing cataracts is more likely to arise from some common visual symptoms.
- Deteriorating clarity of vision. Some people don’t identify an actual change in the quality of their sight. Instead, they may be more likely to notice certain activities are becoming more difficult. For example, where you once were able to easily read the scrolling news headlines at the bottom of the TV screen, you now find yourself squinting.
Another commonly reported concern is when people with cataracts feel they need to get much closer to street signs than previously before being able to read them when driving.
In other cases, a person may be able to describe the deterioration of their sight as blurry, cloudy, hazy, or filmy.
It’s this aspect of cataract symptoms that often drives people to look into cataract surgery.
- Increased discomfort with bright lights. This is also known as glare sensitivity or photophobia. As the opacities of a cataract can scatter light, you may find you become increasingly sensitive to glare and lights. This may manifest as feeling particularly uncomfortable when driving at night, as you are often faced with oncoming car headlights or street lamps. The impact of cataracts on glare sensitivity may also be apparent when backlight signage or LED signs also become more difficult and uncomfortable to read, especially when the ambient lighting is low.
- Poorer vision in dim lighting. In addition to discomfort in bright lighting, dim lighting can also present a problem when cataracts begin developing. This aspect of cataracts is known as contrast sensitivity. The most common manifestation of decreasing contrast sensitivity is finding it more challenging to read in poorer lighting. Many patients will report finding that they now need to bring their newspaper right to the window to read the print, or they realise they need a bright lamp shining right on the page when reading indoors.
- Altered colour perception. This is not often noticed, but some people with occupations or hobbies requiring fine colour discrimination may be aware of this change in their sight. A common form of age-related cataract known as nuclear sclerosis develops as a yellowish-brown haze. This has the effect of absorbing certain wavelengths of light, which alters the colour of the world seen through the cataract.
The impact of these symptoms on a person’s lifestyle and daily tasks is often what guides the timing of cataract surgery. If you’re still getting along quite comfortably despite these changes to your sight, cataract surgery can be safely deferred (and this is often what’s recommended). Alternatively, if you have another condition that would benefit from eye surgery and can be combined with your cataract surgery, you may be advised to go ahead with the cataract surgery earlier. An example of this is certain glaucoma eye surgery procedures that are often performed at the same time as cataract surgery.
What Does a Cataract Look Like to Your Eyecare Professional: Diagnosis of a Cataract
Diagnosing a cataract is often done during a routine eye exam, even before you notice any changes to your sight. Both optometrists and ophthalmologists (eye specialists) are capable of diagnosing a cataract. However, only ophthalmologists are qualified to perform eye surgery to remove it.
When assessing cataracts, your eye care professional will perform a couple of common tests.
- Visual acuity testing. This is done by asking you to read black letters against a white background, set at a certain distance. The result is recorded as the smallest size of letters you’re able to read accurately.
- Slit lamp examination. The slit lamp is a useful piece of equipment comprising a microscope system and a light source. Through the slit lamp, your eye care professional is able to view your cataracts directly. What does a cataract look like behind the slit lamp? Through this microscope, your eye care professional will be able to see any alterations to the transparency of your crystalline lens. Depending on the type of cataract, this may typically look like discolouration of the centre of the lens (nuclear sclerosis), white or grey spoke-like opacities radiating from the edge of your lens (cortical cataracts), or a dense plaque on the back surface of the lens (posterior subcapsular cataract). There are also a number of other cataract presentations, including bluish flecks, snowflake-like opacities, and white spots.
The appearance of a cataract is not usually a cause for alarm, as they’re considered to be a normal part of ageing. By being attentive to your vision and keeping to your scheduled eye check-ups, your eye care professional will be able to monitor the development of any cataracts and advise you when cataract surgery may be recommended.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.