Cataracts are clumps of protein that collect on the lens of an eye and
interfere with vision. Normally, light passes through the lens (the clear tissue
behind the pupil) and focuses on the retina. The retina is the light-sensitive
layer of the eye that sends visual signals to the brain. A cataract occurs when
the normally clear lens becomes cloudy. Most cataracts develop slowly over time
and are a natural result of aging. Once cataracts become large enough that
vision loss interferes with everyday activities such as driving, reading, or
watching television, they should be surgically removed. |
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Signs and Symptoms |
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- Decreased or blurred vision (often described as a "fog")
- Double vision
- Halo around lights
- "Second sight" -- when an individual who normally wears reading
glasses can suddenly read without them
- Brown spots in the visual
field
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What Causes It? |
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A cataract develops when protein in the lens clumps together and blocks light
from reaching the retina. It is not clear what causes these proteins to clump
together, but some researchers speculate that cataracts may develop as a result
of chemical changes in the lens that occur with aging. Other researchers believe
that there may be several causes of cataracts including smoking, diabetes, and
excessive exposure to sunlight.
There are several different types of cataracts:
- Age-related cataracts—those that develop with
older age
- Congenital cataracts—those that are present
at birth or develop in early childhood, usually in both eyes
- Secondary cataracts—those that develop in
individuals with medical conditions (such as diabetes) or in those who use
steroids
- Traumatic cataracts—those that develop as a
result of an eye injury
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Who's Most At Risk? |
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The following factors may increase an individual's risk for developing
cataracts:
- Being older than 50 years of age
- Genetic diseases (such as Down syndrome)
- Certain medications (such as steroids)
- Maternal infection (such as rubella), drug ingestion, or radiation
therapy during pregnancy
- Metabolic disorders (such as diabetes mellitus)
- Eye disorders (such as glaucoma)
- High-voltage electrical
injury
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What to Expect at Your Provider's
Office |
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Individuals experiencing symptoms associated with cataracts should see an eye
care professional. He or she can make a diagnosis and help determine which
treatment or combination of therapies is most appropriate.
Eye care professionals can detect cataracts with the following tests:
- Visual acuity test—measures vision at various
distances
- Pupil dilation—the pupil is widened with eye
drops to reveal more of the lens and retina
- Tonometry—measures fluid pressure inside the
eye
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Treatment Options |
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Prevention |
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- Wear ultraviolet (UV)-blocking sunglasses
- Abstain from smoking cigarettes
Certain medications may help delay cataract formation (particularly in those
with diabetes or other high-risk conditions), but none are known to reverse the
progression of cataracts once they form. |
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Drug Therapies |
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- Eye drops (containing phenylephrine and homatropine) may be prescribed
to dilate the pupil and provide better vision in some individuals
- Aldose reductase inhibitors may help prevent or delay cataract
formation in people with diabetes
- Antibiotics and steroid eye drops may be prescribed following the
removal of cataracts
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Surgical and Other
Procedures |
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In its early stages, a cataract usually does not interfere with vision. Over
time, however, a cataract may grow larger and cloud over more of the lens,
making it difficult to see. When cataracts cause vision loss that interferes
with everyday activities such as driving, reading, or watching television,
surgery is the only effective treatment. An eye care professional may also
recommend that an individual remove a cataract if he or she has other eye
conditions, if the cataract threatens to cause another eye disorder, or if the
presence of the cataract prevents examination or treatment of another eye
problem. During surgery, the cloudy lens is replaced with a substitute lens.
Cataract removal is one of the most common operations performed in the United
States today. According to the National Eye Institute, roughly 90% of people who
have cataract surgery experience improved vision as a result.
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Complementary and Alternative
Therapies |
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A comprehensive treatment plan for cataracts may include a range of
complementary and alternative therapies. |
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Nutrition |
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- Antioxidants may protect the lens against damage caused by free
radicals. Dark leafy greens, orange and yellow vegetables, vitamins A and C, and
beta-carotene are good sources of antioxidants. Dark berries, particularly
blueberries, may also help protect the lens.
- Glutathionine supplements may protect against UV light; selenium
supplements also help keep glutathionine in its active form
- Vitamin E may also protect the lens against free radical damage.
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Herbs |
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The use of herbs is a time-honored approach to strengthening the body and
treating disease. Herbs, however, contain active substances that can trigger
side effects and that can interact with other herbs, supplements, or
medications. For these reasons, herbs should be taken with care, preferably
under the supervision of a practitioner knowledgeable in the field of botanical
medicine. A healthcare practitioner may recommend the following herbs for the
treatment of cataracts:
- Dusty miller (Cineraria maritima) succus (preserved plant
juice); may cause eye irritation
- Bilberry (Vaccinium myrtillus)
- Ginkgo (Ginkgo
biloba)
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Homeopathy |
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Although very few studies have examined the effectiveness of specific
homeopathic therapies, professional homeopaths may consider certain remedies for
the treatment of cataracts based on their knowledge and experience. Before
prescribing a remedy, homeopaths take into account a person's constitutional
type. A constitutional type is defined as a person's physical, emotional, and
psychological makeup. An experienced homeopath assesses all of these factors
when determining the most appropriate treatment for each
individual. |
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Physical Medicine |
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Contrast hydrotherapy (alternating hot and cold water applications to the
face or back of neck) may improve circulation to the head and facilitate the
transport of nutrients to the eye. |
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Prognosis/Possible
Complications |
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The National Eye Institute estimates that approximately 90% of individuals
who have cataract surgery experience improved vision as a result. Complications
from surgery are rare, but can include infection, bleeding, retinal detachment,
inflammation (pain, redness, swelling), loss of vision, or light flashes. With
prompt medical attention, such problems can usually be treated successfully.
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Following Up |
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A healthcare practitioner may prescribe eye drops or medications to help
healing and control the pressure inside the eye for a few days following
surgery. An eye shield or eyeglasses may also be necessary. A health care
provider will schedule eye exams as needed to check on
progress. |
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Supporting Research |
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Bartlett JO, Jaanus SD. Clinical Ocular Pharmacology. 2nd ed. Boston,
Mass: Butterworths; 1989:807-808, 414-416, 630.
Branch WT Jr. Office Practice of Medicine. 3rd ed. Philadelphia, Pa:
W.B. Saunders; 1994:584, 866-867.
Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles
of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:168, 2208,
2558.
Fraunfelder FT, et al. Current Ocular Therapy. No. 3. Philadelphia,
Pa: W.B. Saunders; 1990:613-618.
Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin,
Calif: Prima Publishing; 1998:193-196.
Newell FW. Ophthalmology: Principles and Concepts. St. Louis, Mo:
Mosby; 1996:369-378, 516.
Wyngaarden JB, et al. Cecil Textbook of Medicine. 19th ed.
Philadelphia, Pa: W.B. Saunders; 1992: 1077, 1308, 2270,
2358. |
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Review Date:
March 2000 |
Reviewed By:
Participants in the review process include:
Richard A. Lippin, MD, President,
The Lippin Group, Southampton, PA; Sherif H. Osman, MD, President, Medical Staff
Harford Memorial Hospital, Falston General Hospital, Bel Air, MD; David Winston,
Herbalist, Herbalist and Alchemist, Inc., Washington,
NJ.
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