Signs of cataracts: find out if you need cataract surgery

Understanding the symptoms of cataracts

Here are some of the first signs of cataracts that mean you might need cataract surgery:

• cloudy vision
• changes in colour vision
• glare while driving
• difficulty with reading
• glasses prescription changes (increased frequency)
• double vision or ghosting of images (especially if only noticeable in one eye)
• progressive need for brighter light for reading
• recent struggle with vision at night and increased sensitivity to light.

As cataracts get worse, vision becomes more cloudy and you might notice worsening of the above symptoms.

What causes cataracts?

• Natural ageing changes (most cataracts are formed this way)
• Previous eye surgery
• Babies can be born with congenital cataracts

What are the different types of cataracts?

There are three different types of cataracts: nuclear, cortical or subcapsular.

• Nuclear sclerotic cataracts usually develop with age. They form deep in the central part of the lens and increase gradually
• Cortical cataracts can be caused by increased risk factors such as diabetes. This type of cataract begins at the edge of the lens and can be described as gradually moving into the centre in a spoke-like manner. Cortical cataracts can develop quite quickly, over a period of months
• Posterior subcapsular cataracts can be caused by taking steroid medication, diabetes, radiation or extreme near-sightedness. This type of cataract forms at the back of the lens. It can make vision blurry and make it difficult to see in bright light. Activities such as driving, especially at night, can be particularly difficult.

How are cataracts diagosed?

Cataracts can be diagnosed fairly easily by an ophthalmologist or optometrist, through a consultation and an eye examination.

What if I suspect I have a cataract?

If you think you may be developing signs of cataracts, you need a professional eye exam by your eye doctor, optician or ophthalmologist (after referral by your GP). If your vision problems can be corrected to an acceptable level with glasses or contact lenses, surgery may be avoided at this time. If your vision loss cannot be corrected by the above measures and if this interferes with your daily activities such as driving or watching television, then you may benefit from cataract surgery.

What does cataract surgery involve?

Cataract surgery is the removal of the cataract and insertion of an artificial lens called an Intraocular Lens Implant (IOL) into the eye. Far more than 90% of patients operated on have a significant improvement in their vision.

Learn more about the latest enhanced cataract lenses and cataract surgery costs.

At what stage should cataracts be removed?

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. Most people choose to have their cataracts removed when the change in their vision starts to cause them difficulties in everyday life. Early-stage cataract treatment means you can improve your vision faster and prevent it from worsening. You can learn about cataract surgery waiting times here.

Are you awake during cataract surgery?

Cataract surgery usually takes about 15 minutes and most people go home from hospital about two hours later. It is done under local anaesthetic, which means you will be awake during the operation. Most of the time drops will be used to numb the eye.

After the operation, you will need to put drops into your eyes for a few weeks.

How can I prevent my cataracts from getting worse?

Lasers are not used to remove cataracts and there is no evidence to suggest that changing your diet, taking vitamins or using eye drops can cure cataracts.

To prevent your cataracts from getting worse, you could try:

• ensuring you have regular eye examinations
• wear sunglasses when out in the sun
• reduce alcohol and smoking
• manage other health issues that increase the risk of cataracts, such as diabetes.

Can cataracts be prevented?

To date, there is no proven method of preventing cataracts. It is very important to have regular eye examinations (every two years for adults and then every year after the age of 50) as conditions that may affect your eye health become increasingly common with age.

Please ask your local optician or talk to your doctor if you have any risk factors or indications that cataracts may be affecting your vision. Risk factors for cataracts include:

• getting older
• diabetes
• obesity
• previous eye surgery or injury
• smoking
• excessive alcohol use
• excessive sunlight exposure.

Cataract signs and symptoms FAQs

What are the first symptoms of having cataracts?

If you have a cataract you may experience:

• blurred vision
• fading colours
• poor night vision
• glare when driving at night
• glare during the day
• double vision
• need to change glasses frequently
• difficulty in reading / seeing your phone
• difficulty in seeing TV text.

What do early stage cataracts look like?

In a healthy eye, the lenses focus the light on a spot on the retina and this gives clear vision. With cataracts, the lens of your eye (which lies behind the iris) becomes increasingly cloudy, like frosted glass and can give you cloudy vision. Your doctor will be able to discuss your symptoms with you and make a decision as to whether they are consistent with the early signs of cataracts.

Can you get cataracts at any age?

Cataracts can start at any age according to the type of cataract, however, the most common form of cataract – nuclear sclerotic – develops over time and due to its nature predominantly affects people over 65 years old.

How quickly do cataracts progress?

Depending on the type of cataract, progression can be months or years. With age related cataracts progress tends to be over years, as the eye lens harden and yellow over time. Progress of cataracts can also be influenced by lifestyle, medication or illness.

How do you tell if your cataracts are getting worse?

Regular eye exams will help detect the first signs of a cataract worsening. You may also experience more difficulty with activities such as driving at night or reading. If you suspect a change, you should make an appointment with an optician or ophthalmologist.

How do you know if you have cataracts or glaucoma?

Regular eye testing is key in monitoring for cataracts and glaucoma. Whilst cataracts are a clouding of the lens, glaucoma is a condition where loss of peripheral vision is caused by damage to the optic nerve. Both cataracts and glaucoma are common eye conditions which share some of the same risk factors.

Can you feel a cataract?

Cataracts do not usually cause pain or discomfort, however, some cataract symptoms can be uncomfortable and affect daily activities, such as; glare, difficulty reading, double vision or sensitivity to light.

Can you see cataracts in the mirror?

When a cataract first forms it will be difficult to see with the naked eye, but over time and, if allowed to progress without treatment, a cataract will become visible and look like a cloudy film over the eye.

What does vision look like with cataracts?

Because cataracts are the result of a cloudy lens, vision may be altered. You may experience double vision, blurring, fading colours, glare or poor vision at night.

Do cataracts cause dry eyes?

Dry eyes can be due to several different causes, but cataracts can lead to dry eyes indirectly. Cataracts lead to cloudy vision, if uncorrected, it can lead to blepharitis (inflammation of the lid margins), which could lead to changes in the tear film leading to dry eyes. If you are experiencing dry eyes alongside other eye problems it is always good to see an eye doctor just to be sure.

Do cataracts make your eyes water?

Cataracts lead to cloudy vision, if uncorrected, it can lead to blepharitis (inflammation of the lid margins), which could lead to changes in the tear film leading to dry eyes and watery eyes secondarily. If you are experiencing dry eyes alongside other eye problems it is always good to see an eye doctor just to be sure.

Can you self-test for cataracts?

If you have the symptoms or signs of cataracts described in this article, you can book an appointment with an optician or ophthalmologist. Meeting with a professional, describing your symptoms and having an eye exam will result in early diagnosis and help you get prompt treatment.

Hear more answers to your cataract questions in the webinar with top ophthalmologist Mr Ernest Onyema.