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What you need to know about the cataract
In everyday life, we often do not even notice our ability to see. However, even the smallest change that occurs in this ability for any reason directly affects our quality of life. When we wake up one morning feeling as if our glasses are constantly fogged up, when we notice that colors no longer look as vivid as before, or when driving at night gradually becomes more difficult, we once again realize how important vision actually is. Cataract often enters our lives in exactly this way, slowly and quietly.
In this article, we discuss what cataract is, who it affects, and why it occurs, how its symptoms progress, and which treatment options are available today. If you want to better understand the changes in your vision and learn more about the cataract, this article is just for you.
What is a cataract?
Cataract is a condition in which the natural lens inside the eye, which enables clear vision, gradually loses its transparency and becomes cloudy. This clouding prevents light from being properly focused onto the retina and leads to a decrease in vision.
This vision problem can occur at any age; some babies are even born with cataracts. However, it is most commonly seen in later stages of life. For example, it is known that approximately 70 percent of people over the age of 75 have cataracts. It is estimated that more than 20 million adults over the age of 40 (about 17 percent) have cataracts.
Vision loss caused by this quite common condition can be treated with surgery in most people. Cataract surgery, also known as smart lens treatment, is one of the most frequently performed surgical procedures today. After introducing the question of what the cataract is, let us now continue with the types of cataract.
What are the types of cataract? What causes cataract?
To understand the types of cataract, we first need to talk a little about the structure of our eyes. In this way, we will also answer the question of what causes cataracts. For this, let us begin by discussing the lens in our eye, also known as the crystalline lens.
In a healthy eye, the lens consists of specially arranged protein fibers that ensure its transparency. This tissue, which we call the lens or eye lens, has four layers arranged from the inside outward: the nucleus, cortex, lens epithelium, and lens capsule. The cortex surrounds the nucleus, which is located at the very center. Outside the cortex lies the lens epithelium, composed of the living cells of the lens. The outermost layer, which encloses all these structures and gives the lens its shape, is the lens capsule.
In healthy eyes, light rays reflected from an object enter the eye through the cornea and the lens, and together these structures focus the light onto the retina to create a sharp image. However, when a cataract develops, the light rays are no longer focused properly. Instead, they scatter before reaching the retina, which leads to visual problems.
After this introduction, we can now talk about the types of cataract. The three most common types of cataract are defined according to where they occur within the lens. These are nuclear, cortical, and posterior subcapsular cataracts. Another important point to note is that cataract can develop in more than one area of the lens. In other words, a person can have more than one type of cataract in the same eye.
- Nuclear cataract is the most common type of cataract. The risk of developing nuclear cataract increases with age and smoking.
- Cortical cataract is also more common with advancing age. The development of this type of cataract is associated with lifelong exposure to ultraviolet light.
- Posterior subcapsular cataract is more commonly seen in younger individuals. This type of cataract is usually the result of long-term corticosteroid use, inflammation, trauma, or diabetes.
The extent and speed of vision impairment depend not only on the size and density of the cataract but also on its location within the lens. For example, a cataract located at the outer edge of the cortex has little effect on vision because it does not block light passing through the center of the lens. On the other hand, a dense nuclear cataract can cause significant visual blurring.
Cataract symptoms
Some of the most common symptoms of cataract in the eye can be listed as follows:
Blurred and dim vision
Cataract symptoms usually develop without causing pain. The most common symptom is gradually increasing blurred vision. A person may feel as if they are viewing their surroundings through a pair of glasses that need to be cleaned. Although both eyes can be affected by cataract, vision loss is often felt more prominently in one eye. This can make daily activities more difficult without being immediately noticed.
Sensitivity to light and difficulty with night vision
Glare, seeing halos around lights, and reduced night vision are among the common symptoms of cataract. Vision quality may decrease, especially under bright light. Perceiving colors as faded or yellowish and needing stronger light while reading are also complaints that may arise during this period.
Double vision
In some cataract cases, a person may experience double vision even when looking with only one eye. This occurs because light passing through a lens that has lost its transparency and contains irregular opaque areas is refracted in different directions. As a result, the image of a single object is projected onto different areas of the retina, leading to a loss of image clarity.
Frequent changes in glasses or contact lens prescriptions
As cataract progresses, existing glasses or contact lenses may no longer be sufficient. A person may feel the need to change their prescription more frequently. These changes usually occur gradually. Symptoms may appear over months or even years, initially in a barely noticeable way.
Temporary improvement in vision and difficulty seeing in bright light
In the early stages of nuclear cataract, some people may experience a temporary improvement in vision. For example, a person who previously needed reading glasses may notice that they can read without glasses for a short time. This phenomenon, known as “second sight,” is not permanent and disappears as the cataract progresses. In people with cortical or posterior subcapsular cataracts, the opposite may occur: vision becomes even more difficult, especially in bright light, and driving at night may become significantly harder due to oncoming headlights.
Cataract surgery
How is cataract surgery performed?
Cataract treatment is a surgical procedure. During the operation, the natural lens inside the eye that has lost its transparency is removed and replaced with an artificial intraocular lens (IOL). This procedure is also commonly referred to as smart lens treatment. The surgery is usually performed under topical (drop) anesthesia, and the patient does not feel pain during the procedure. The surgeon removes the cloudy lens through a small incision and places the artificial intraocular lens in its place; with this step, the surgery is completed.
Lens selection before surgery
Before the surgery, your surgeon will evaluate the intraocular lens options together with you. Multifocal and accommodating lenses aim to provide clearer vision at near, intermediate, and far distances. Multifocal lenses direct light to multiple focal points through rings with different optical powers. Accommodating lenses attempt to adjust focus by changing position with the movement of the eye muscles. Applying these lenses to both eyes generally provides better results. Approximately 85 percent of people who receive multifocal lenses report that they do not need glasses in their daily lives.
How long does cataract surgery take?
Cataract surgery is generally a short procedure. The operation itself is usually completed within 10–20 minutes. Including preparation and a short rest period afterward, patients can typically return home the same day.
Is there pain after cataract surgery?
After cataract surgery, pain is minimal or absent in most patients. Mild itching, a stinging sensation, or discomfort in the eye may occur in the first few days and is usually temporary. However, in rare cases, some people may experience moderate to severe eye pain that can last for weeks. For this reason, it is important to inform the doctor about any existing eye pain before the surgery.
What is the recovery process like after cataract surgery?
The recovery process usually progresses smoothly. Vision gradually becomes clearer in the days following the surgery. While mild discomfort in the first few days is considered normal, a doctor should be consulted if complaints increase or do not decrease within a few days. Using over-the-counter medications without consulting a doctor is not recommended. Regular use of the prescribed eye drops and attending follow-up appointments are important for a healthy recovery process.