What are the symptoms of cataracts?

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Cataracts generally develop slowly and may not cause any symptoms at first.

Over time, the cataract may grow and cause vision changes. A person with cataracts may have one or more of the following symptoms:

• decreased vision
• blurred vision
• double vision
• polyopia, or seeing two or more images arranged in ordered rows after fixing eyes on a stimulus
• sensitivity to glare from lights, including headlights
• colored or rainbow halos around lights
• a repeated need to change eyeglasses or contact lens prescriptions
• objects looking faded
• objects appearing yellow

Learn about the early signs of cataracts.

The lens consists of fibers enclosed in a capsule. It has two main parts: the cortex, which is the outer part with younger fibers, and the nucleus, the deeper part with old fibers.

Types

A cataract may develop in any part of the lens, and their names correspond to the layer from which they form. The types are as follows:

• Posterior capsular cataract: This is a cataract in the back outer layer of the lens. This type usually develops rapidly.
• Cortical cataract: This is a cataract in the lens surrounding the nucleus. This looks like a spoke or a wedge.
• Nuclear cataract: This is a cataract at the center of the lens. This type tends to darken with age, changing from clear to yellow or sometimes brown or black.

Causes

Most cataracts occur due to age-related changes in the eye’s lens, in which proteins break down and clump together.

Other factors that may cause or contribute to cataract development include:

• injury
• chemical injury
• smoking
• alcohol use disorder
• X-ray exposure
• being undernourished
• systemic conditions such as diabetes
• uveitis
• long-term exposure to UV light
• exposure to infrared heat

Learn more about different types of cataracts.

Cataract treatment depends on the level of visual impairment they cause. If they cause minimal visual impairment, doctors may recommend pupillary dilatation or refractive glasses to help improve vision.

A doctor may recommend cataract surgery when:

• the cataract progresses to the point that it affects the person’s ability to carry out their daily activities
• their visual acuity drops below 20/80 vision
• there is a medical indication for surgery, such as:
  • retinal detachment
  • phacomorphic glaucoma
  • phacolytic glaucoma

Surgery types

Cataract surgery involves removing and replacing the person’s lens with an artificial lens. Eye surgeons use one of two approaches for removing the lens.

Small incision cataract surgery with phaco-emulsification involves making an incision in the side of the cornea where they insert a probe. The probe emits ultrasound waves that break up the lens so the doctor can suction it.

Extracapsular surgery involves making a larger incision in the cornea to remove the whole lens as a solid piece and replace it with an intraocular lens.

Learn more about different types of cataract surgery.

To assist with diagnosing cataracts, an eye doctor may begin by asking questions about symptoms, taking a full medical history, and performing an eye examination.

Various tests can help with diagnosing cataracts. They may include:

• visual acuity, which measures the sharpness of vision
• refraction measurement
• pupil dilation to evaluate the retina
• measurement of pressure within the eye
• color vision and glare sensitivity tests

The eye doctor will be able to explain the tests they recommend and answer any questions about what they involve.

Below are answers to some commonly asked questions about cataracts.

What are the first signs of having cataracts?

Cataracts develop slowly and may not cause symptoms at first. When symptoms do occur, they can include cloudy or blurry vision and glare.

How do your eyes feel when you have cataracts?

People with cataracts develop a range of vision changes. They typically do not cause pain, but their other symptoms, such as glare sensitivity, may cause discomfort.

What is the average age at which cataracts develop?

The protein in the lens starts breaking down around the age of 40 years. Age-related cataracts may slowly develop over time. According to the National Eye Institute, over half of Americans ages 80 and over have cataracts or had cataract surgery.

Cataracts are a clouding of the eye lens that typically occurs due to age-related changes. Other contributing factors can include certain health conditions and injury to the eye.

Symptoms may include blurred vision, double vision, and difficulty seeing at night. Symptoms may start gradually and develop over time.

Treatment for cataracts depends on the severity of visual impairment. When symptoms are mild, prescription glasses may be enough, while doctors typically recommend surgery in more severe cases.