Cataracts are generally an age-related condition that occurs when the lens inside the eye that focuses the light into the back of the eye, becomes cloudy and opaque causing:

• Dimming of vision
• Glare sensitivity at night time
• Concerns about clarity of vision in low light or poor contrast situations

What are cataracts?

The word cataract comes from the Latin cataracta, which means waterfall. A cataract is a clouding of the normally transparent lens in the eye.

The lens works together with the cornea to focus light onto the retina which converts light to electrical signals that are transferred to the brain. This gives us the images we see. A cataract can scatter the light, and blur the images on the retina.

Cataracts develop slowly and painlessly and they can progress for many years going undetected until, if left untreated, cause severe visual impairment. Regular eye exams with your optometrist are key to early detection and prevention of vision loss.

With a cataract, a person might have discomfort with night time driving, and general reticence in low-light, with many people commenting they have stopped driving at night. They just can’t see things as well as they should and will often complain that newspaper print is getting much smaller or poorer in contrast, and they may stop doing other things they like to do in the evenings like knitting or sewing.

What causes cataracts?

Most cataracts develop when ageing or injury changes the tissue that makes up the lens in the eye. Some inherited genetic disorders that cause other health problems can increase your risk of cataracts. Cataracts can also be associated with other medical conditions like diabetes, after other unrelated eye surgery or in association with taking some medications.

Several uncontrollable factors may increase the risk of developing cataracts, including:

• Age
• Family history
• Ethnicity
• Some studies also suggest that women may be at a slightly higher risk than men

Research shows we can control several risk factors for cataracts by changing certain behaviours, including:

• Not smoking
• Reducing exposure to UV
• Controlling other diseases such as Diabetes and Hypertension
• Eating a healthy diet

Who is affected by cataracts?

In an ageing population, largely everyone can be affected by cataracts. Yet, those that are affected earlier, tend to be those that have had that high sun exposure.

Sometimes if there has been trauma to the eye, we will see someone come in with advanced cataracts at a much earlier age. In addition, people who have been on some medications, particularly steroidal-based medications, can have early cataracts. Sometimes people who have had cancer treatment and have been prescribed steroids as part of their treatment, and they might present earlier with cataracts.

Nutrition is also a known factor in the early development of cataracts. We know that those who have poor nutrition at an earlier age, for example, people in the Second World War who had very poor nutrition in Holland ended up with early cataracts.

Smokers tend to have much worse eye health in general.

Predominantly though in Australia the risk factors are age. We are all living a lot longer than what we ever did, so it is something that has the potential to affect everybody at some stage.

Factors that can increase the risk of developing cataracts include:

• long-term unprotected UV exposure
• excessive alcohol intake
• diabetes
• high blood pressure
• a family history of cataracts
• use of corticosteroid medicines for a prolonged period
• smoking

How are cataracts diagnosed?

For the diagnosis of cataracts, what is most important as an optometrist is to ask the questions that might indicate whether there are any signs of eye disease and to perform a comprehensive eye examination to link the symptoms with any signs of disease. An optometrist will use an ophthalmoscope to examine the inside of your eye and a slit lamp biomicroscope, which will allow them to see more detail about the size and location of the cataracts.

What is the treatment for cataracts?

Surgery is the only cure for cataracts. As your optometrist, we will refer you to an ophthalmologist (eye surgeon) for surgery. Sometimes the eye surgeon will ask the patient what they would like regarding their need for vision after the procedure, and as your optometrist, we may trial a contact lens to show what your vision may look like after surgery. Patients find that useful.

Finding the right surgeon for our patients is an important decision that we as optometrists make, as different surgeons have different approaches. Generally, the techniques used for modern-day surgery are fabulous and a patient can often choose where they want to see better – for distance or for reading, in which case the surgeon can customise the lens implants they use. This is often a discussion that we have with our patients as prioritising vision for specific needs is a skill optometrists use every day. Patients can be enabled to read without their glasses or they can manage the computer work without their glasses or maybe no longer need distance driving glasses after a procedure. As the primary care practitioner, we see the results after the surgery and we know where you may or may not need support. We have all of your history in the build-up to that cataract developing, so the referral letter for cataracts comes from your optometrist and a copy goes to your general practitioner.

For assistance with all your eye care needs, visit your nearest Kosmac & Clemens Optometrists team today. Contact us for diagnosis, treatment and management of cataracts in Bendigo, Castlemaine, Kyneton, Maryborough, Heathcote and Woodend.