Cataracts are a common condition affecting many older people across the globe. In fact, more than half of people over the age of 65 experience clouding of the lens of the eye. Advancing age is a major risk factor for the development of cataracts. People with a family history of cataracts are also prone to have cataracts earlier on. Other factors that can contribute to cataract formation are cigarette or tobacco use, air pollution, heavy alcohol consumption, prolonged exposure to the UV rays of the sun, and the presence of diabetes.

A cataract is opacity or clouding of the lens of the eye. It can occur in either or both eyes but it cannot spread from one to the other. The lens is the clear part of the eye and by changing its shape, the lens helps the eye to focus on objects at various distances.

In the normal eye, the light passes freely through the lens. The light is focused on the retina, which is a light sensitive part found at the back of the eye. It is here where the signals are sent to the brain. For the retina to receive a sharp image, the lens of the eye must be clear. If the lens is cloudy due to cataract formation, then the image seen will be blurred.

The lens is composed mainly of water and protein. The protein is set up in such a way that it keeps the lens clear and the light can pass through it. With advancing age, the protein, notably those called alpha crystallins, may clump together and then start to cloud a small part of the lens. Usually they develop slowly over several years and are mainly related to ageing. This results in decreased sharpness of the images that reach the retina. The images appear blurry or hazy. If left untreated the proteins in the lens can stick together, grow larger and obscure more of the lens. Other symptoms include increased sensitivity to glare such as headlamps and sunlight. Colours may appear less vivid or may come out as faded.

In the early stages, vision can be improved by using stronger prescription glasses or contact lenses as well as strong bifocal lenses if needed. The use of a magnifying glass during reading fine print can help. The use of stronger lighting in the home is also recommended. Some eye doctors can prescribe medications that dilate or open up the pupil to allow more light to pass through. However, not all patients can benefit from this treatment.

The cataracts do go not away but can stop progressing at a certain point. For cataracts that continue to grow and develop, these need to be removed by surgery.

Cataracts are not a medical emergency. They usually do not harm the eyes so cataract surgery can be done at a later stage. The patient has plenty of time to carefully consider the options and discuss them with the eye surgeon before deciding when to undergo an operation. Cataract surgery is done on an outpatient basis.

In the past, cataracts were removed only when the cataract had become well developed and has almost completely interfered with vision. Modern techniques are now available to allow eye surgeons to do cataract surgery even in its earlier stages.

Extracapsular cataract extraction or ECCE is type of cataract surgery that involves making an incision on the side of the cornea and then removing the central core of the lens in one piece. When the natural lens has been removed, a replacement lens is put in its place.

Phacoemulsification is a type of cataract surgery in which the cloudy lens is liquefied using ultrasound. The cataract is broken into tiny pieces and then carefully suctioned from the eye through as very tiny incision. A replacement lens is then inserted and becomes a permanent part of the eye. Phacoemulsification is the most common cataract surgery procedure. Healing and recovery is quick, with almost no discomfort to the patient.

A type of refractive surgery called refractive lens exchange or RLE is also an alternative to treating cataracts. Older adults with high refractive errors along with early cataracts symptoms can choose to have RLE instead of waiting for the cataracts to become advanced enough to necessitate surgery. Refractive lens exchange involves replacing the natural lens with a permanent lens implant. The implanted lens corrects the refractive error and in addition, it will never develop cataracts in the future.