The different stages of cataracts explained

How many stages of cataracts are there?

As you get older, the lens inside your eye gradually changes and becomes less transparent. This can affect your ability to see.

There are several different types of cataracts. These include:

• nuclear cataracts
• age-related cataracts
• posterior subcapsular cataracts
• cortical cataracts.

All of these evolve through four distinct stages of progression:

• early cataracts
• immature cataracts
• mature cataracts
• hypermature (advanced) cataracts.

Cataract development stage one: early cataracts

In the early stages, cataracts may not cause noticeable symptoms. Vision changes may be subtle.

Early stages of cataract symptoms

In this early stage, you may not have many noticeable symptoms. However, you may spot some subtle changes in your vision. These can include:

• increased sensitivity to glare or halos around lights
• mild blurring
• increased eye strain.

What do early stage cataracts look like?

Early cataracts may not be visible to the naked eye. Eye specialists often detect them during routine eye health exams, so it’s important to attend regular appointments. This becomes increasingly important as you get older.

Early stage cataract treatment

While symptoms are generally mild during early cataracts, there are still steps you can take to alleviate them.

Updating your glasses prescription and opting for an anti-glare coating can improve your vision. Try to use brighter lighting for reading and other activities.

Another important measure is to wear sunglasses that block ultraviolet (UV) rays to help manage sensitivity to light.

Can early stage cataracts be reversed?

Early intervention, healthier lifestyle choices, and reduced exposure to risk factors can slow down the progression. They can also help to alleviate symptoms and delay the need for surgical intervention.

Stage two: immature cataracts

During this stage, the clouding of the lens becomes more apparent. While vision changes may be noticeable, they might not significantly impact your daily activities.

Symptoms

As the cataract develops into the immature stage, symptoms become more obvious. For example, you may experience:

• blurred vision
• colours appear less vibrant
• difficulty reading
• poor night vision
• increased sensitivity to light
• double vision.

What do stage two cataracts look like?

Clouding of the lens will become more visible during this stage.

Treatment

Frequent prescription changes and brighter lighting can help manage symptoms during this stage. Regular eye health checks are important to monitor the progression of symptoms and determine the appropriate time for surgery.

Stage three: mature cataracts

As cataracts progress, your vision impairment will become more noticeable. Activities such as driving and recognising faces may become challenging.

At this point, it’s important to seek medical advice for further evaluation and treatment. This will usually involve surgery.

Symptoms

When a cataract progresses to the mature stage, symptoms may become more severe and can seriously impact your quality of life. They could include:

• pronounced blurriness or haziness
• colours appear faded
• difficulties with near and distant vision
• everyday tasks like driving and recognising faces becomes more difficult.

What do stage three cataracts look like?

Mature cataracts can be almost entirely white or yellow in colour and you may no longer be able to see a shadow cast by the iris edge.

Treatment

At this stage, surgery is usually recommended. Cataract surgery involves replacing the cloudy lens with an artificial intraocular lens.

Cataract surgery is the most successful and most frequently performed operation in the UK. Every year, more than 400,000 cataract procedures are carried out in England, with over 90% of patients reporting a significant improvement in their vision.

Stage four: hypermature or advanced cataracts

At the mature stage, cataracts have reached their peak and are likely to cover most of the lens. Vision is severely compromised, and you may only be able to perceive light and dark with minimal form and detail.

Symptoms

Advanced cataracts can lead to significant blurring of vision or even complete vision loss.

Performing routine tasks may become extremely challenging. This can have a severe impact on your overall independence.

What do stage four cataracts look like?

During the advanced stage, the lens becomes shrunken with white spots. It may also partially dislocate at times or develop from secondary glaucoma.

Treatment

Cataract surgery remains the primary treatment option. However, there is a higher likelihood of complications if you wait longer to treat it.

Cataract progression timeline

It’s important to remember that everyone’s timeline can look different when it comes to the development of cataracts.

Cataracts tend to get worse over time and the operation can be performed at any stage of cataract development. There is no need to wait until your cataract is “ripe” before removing it.

How quickly do cataracts progress?

Cataract progression varies from person-to-person. Factors such as age, genetics, and lifestyle choices (i.e. smoking and diet) can influence the speed at which cataracts develop.

How do you tell if your cataracts are getting worse?

Regular eye exams are crucial for monitoring cataract progression. If you notice worsening symptoms, talk to your eye care professional.

At what stage are cataracts removed?

Most people choose to book their cataract surgery when the change in their vision starts to impact their quality of life. The decision to have surgery is an individual one based on your symptoms and lifestyle.

If you or a loved one is suffering from the symptoms of cataracts, get in touch to see if cataract surgery is right for you. Early intervention can significantly improve your vision and enhance your quality of life in the long run.

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