There are many changes that happen to our eyes and vision as we age.  One of the most common aging conditions to affect our vision is the development of cataracts.  A cataract is a clouding of the natural lens in our eyes due to changes of its protein structure.  The lens is the part of the eye that helps focus light or an image clearly to the back part of the eye called the retina.  From here, the image is processed and sent to the brain via specific nerve signals.  Once protein changes start occurring, they block the passage of light and the ability of the retina to view the image clearly.  In essence, clumps of protein will create a yellowing of the previously crystal clear lens and result in deterioration of our vision quality.   

There are many reasons for these changes to our natural lens.  Aging by far is the most common reason.  In fact majority of the population by the time they reach their 70s will have significant cataracts. The process actually starts in your early fifties.  The protein in our eye’s lens start undergoing changes; however, the process can vary in its rate of deterioration based on each individual.  Some more common conditions that can accelerate this process include previous history of trauma, smoking, diabetes and steroid use.  Cataracts can also present earlier if there is a history of long-term exposure to ultraviolet rays (excessive sunlight).  Also medications can lead to early development of cataracts.   

Usually, the protein changes occur very slowly and our vision is affected gradually.  As noted before, the process starts usually in our early fifties, but doesn’t become significant till late fifties or sixties.  The most common symptoms include difficulty with contrast in low light conditions and night vision.  Certain cataracts can also lead to difficulty reading and adjusting to bright lights causing excessive glare.  Color vision is also affected as colors will seem faded or dull.  Because the process is very gradual (usually taking years to develop), most patients don’t realize the change in vision.    

Mild cataracts most often can just be observed.  Cataracts can lead to a change in glasses prescription, doing so may help temporarily, but most patients will find it difficult to see well at night due to glare.  As the protein denaturation process of the lens continues, they symptoms will worsen.  When symptoms start affecting the quality of vision where doing tasks such as driving safely at night, reading or doing computer work becomes difficult and strenuous, it’s important to discussing treatment options.  The most effective and common treatment is surgery to remove the defective lens and its protein build-up.  Currently, the state-of-art surgery involves a minimally invasive procedure that usually requires no stitches or patches and takes only a few minutes.  The surgery is performed on an out-patient basis and patients can resume their normal activities within a day or two.  There is no hospitalization needed.  In addition to this small incision technique there are also some significant advances in lens replacement options.  Patients who currently wear glasses can also benefit from placement of special lenses in their eyes during the time of the surgery to eliminate the need for glasses.  The placement of this special lens may cost the patient out-of-pocket dollars.  Most insurance companies do not pay for the lens that may eliminate the need for eye glasses. These options should be carefully discussed with your surgeon prior to the surgery.  Once the cataract is removed, it does not recur, ever.   

The naturally aging change to our lens due to protein denaturation is almost inevitable.  Almost everyone will suffer from some degree of cataracts.  Some research suggests that taking vitamins and anti-oxidants may have a beneficial effect on slowing down the process.  Controlling other medical conditions such as diabetes or decreasing steroid use has shown benefits.  Avoiding excessive ultra-violet rays (wearing sunglasses or a low brim hat) over your lifetime also has protective effects.  It is extremely important that patients over 50 get an annual eye exam to screen for cataracts and other age-related conditions and treat them before they cause irreversible damage to the eye.

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