Cataracts Symptoms Explained: What You Need to Know

Cataracts are one of the leading causes of vision loss in the United States and around the world. They typically form gradually and may not cause noticeable symptoms or discomfort in the early stages.

However as the condition progresses, it can begin to interfere with a patient’s ability to read, drive, and engage in everyday activities. Recognizing cataract symptoms can help patients take action sooner, allowing them to protect long-term vision.

A cataract forms when a patient’s natural lens begins to cloud, limiting the amount of light that passes through the eye. This causes vision to be dim and blurred, and can make daily activities more difficult.

As the lens continues to cloud, patients may experience other issues such as blurry vision, trouble reading, or in serious cases, vision loss. Cataracts develop slowly and may not be immediately apparent to the patient. In fact, patients may not realize they have a cataract until they receive a diagnosis or experience cataract symptoms that affect their vision.

Cataracts range in severity. Mild cataracts, which occur early on, are typically not visually disruptive. In fact, many patients may not be aware they have a cataract during earlier stages.

When patients do show symptoms of mild cataracts, they may be able to alleviate them through a new glasses prescription and lifestyle changes such as protecting the eyes from UV light, and reducing smoking and alcohol intake.

However, later-stage cataracts can have more severe consequences including loss of vision. When patients begin to notice that their cataract is disrupting their day to day activities it might be a sign that surgery is required.

Cataracts are most commonly caused by the natural aging process. Over time, the proteins in the eye’s lens begin to break down and clump together, leading to cloudiness that worsens gradually.

While aging is the primary factor, several other risks can increase the likelihood of developing cataracts earlier or more severely:

• Long-term sun exposure: UV radiation from sunlight can damage the eye’s lens over time, especially without proper eye protection.
  

• Smoking: Tobacco use increases oxidative stress in the eye, which may accelerate cataract formation.
  

• Excessive alcohol use: Heavy alcohol consumption may also contribute to lens damage and earlier onset of cataracts.
  

• Medical conditions: Diabetes and other systemic diseases can raise the risk of developing cataracts. Other eye diseases and systemic conditions may also contribute to the development of cataracts.
  

• Medications: Prolonged use of corticosteroids has been linked to a higher risk of cataracts.
  

• Eye trauma or surgery: Injuries or past surgeries involving the eye may trigger cataract formation.

• Family history of cataracts: Genetics can play a role in early development.

In the early stages, cataracts may not cause noticeable vision problems. But as the lens becomes increasingly cloudy, patients may begin to experience subtle changes in how they see the world:

• Blurry or cloudy vision: Objects may appear slightly out of focus or hazy, often described as looking through fog or a smudged lens.
  

• Faded or dull colors: Colors may lose their vibrancy, making the world look washed out or less vivid.
  

• Prescription changes: Glasses or contact lenses may no longer seem to improve vision as effectively as they once did.
  

• Increased sensitivity to light: Bright sunlight or headlights can become uncomfortable or overwhelming.
  

• Glare or halos around lights: Especially noticeable at night, many patients report difficulty driving due to these visual distortions.

• Difficulty reading in dim light: Small print becomes harder to see, and low-light conditions may worsen clarity. Words on a page may appear warped or doubled, as if seen through a smudged magnifying glass.

• Double vision in one eye: Some patients experience ghosted or overlapping images, particularly as the cataract progresses.

Because the signs of cataracts often develop slowly, they can be mistaken for normal aging or eye fatigue. It's important to bring up any changes in vision during routine eye exams so they can be properly evaluated.

Cataracts typically worsen slowly, which means symptoms may become more noticeable over time. What starts as mild blurriness or light sensitivity can gradually develop into more significant vision impairment.

As the lens becomes cloudier, patients may struggle with everyday tasks like reading, watching television, recognizing faces, or driving, especially at night. Glare from headlights or streetlights may become overwhelming, and colors may appear increasingly washed out or yellowed.

Over time, many patients find that frequent updates to their glasses or contact lens prescription no longer improve their vision. This is often a key sign that the cataract has advanced to the point where surgery may be necessary to restore clarity and quality of life.

If a patient is experiencing cataract symptoms, they should go to the eye doctor for a check-up. To diagnose a cataract, the ophthalmologist will look at the patient’s medical history and conduct a comprehensive eye exam.

During the exam, the eye doctor dilates the patient's eye. This widens the pupil, allowing the doctor to clearly look inside the eye. During a dilated eye exam, the doctor can examine the back of the patient’s eye to determine if they have a cataract and how much of their vision is blocked.

A visual acuity test is also commonly performed to determine how much the cataract is affecting the patient’s sight.

There are a variety of treatments for cataracts. The treatment an ophthalmologist recommends depends on the severity of the cataract and when they spot it. While there’s no guaranteed way to prevent cataracts, steps can help patients manage the condition.

Typically, early cataracts don’t require surgery. Patients can alleviate many of their symptoms with a change in glasses prescription. Doctors may also recommend lifestyle changes that help manage cataract symptoms. Some include:

• Wear sunglasses with UV protection or other protective eyewear to limit exposure to harmful light

• Quit smoking if it’s a habit

• Reduce alcohol intake

• Use brighter lights for reading

• Take care of health problems, especially those related to diabetes

For more severe cataracts that cannot be managed by lifestyle changes or a new glasses prescription, an eye doctor may recommend cataract surgery. Cataract surgery is typically recommended for patients with severe cataracts that disrupt day-to-day activities. Surgery is the most effective way to treat cataracts when vision loss becomes significant

Eye doctors may also suggest surgery if a cataract gets in the way of other eye treatments and diagnoses, particularly ones where the doctor needs to see the back of a patient’s eye.

During surgery, the eye doctor will remove the cloudy lens and replace it with a clear artificial lens, also called an intraocular lens (IOL). This clear lens allows the patient to enjoy clearer, crisper vision. Cataract eye surgery is considered safe and effective, with a success rate of around 98%.

During cataract surgery, patients will have a number of intraocular lenses to choose from. Different lens types may suit different patients depending on their conditions, budget, and the results they hope to achieve:

Monofocal: Standard single-focus lens implant. It will cover only one vision range (distance, intermediate, or near). The cost is covered by insurance.

Multifocal: High-performance upgrades that correct for multiple visual ranges, giving patients freedom from glasses at all ranges. These are not covered by insurance.

Toric: Special lenses that correct astigmatism. Some monofocal and all multifocal lenses have toric versions available. Toric lenses are not covered by insurance.