CATARACTS

WHAT ARE CATARACTS?

The origin of the term Cataract originates from the Greek word "kataraktes" which first referred to the white water seen at the bottom of a waterfall.  As you can see, the white water looks similar to the way advanced Cataracts can sometimes appear in the human or animal eye. 

Cataracts can be defined as any opaque area of the intraocular lens of either eye. 

There is a lot of variability with Cataracts, as they could take up the entire lens, or be confined to small areas.  You could be born with them or develop them later on in life from many causes like aging, medications, health problems, eye injuries and more. 

One type of "cataract" refers to waterfalls.

DIFFERENT TYPES OF CATARACTS

There are over a dozen types of Cataracts and we will discuss the most common ones below. 

TRAUMATIC:

Traumatic Cataracts can form from blunt eye injuries, inflammation, and chemical or radiation damage. 

With blunt trauma, the capsule of the lens can rupture leading to a severe, white opacity that causes vision loss very quickly after the injury.  Cataracts due to radiation usually won't happen as quickly after the exposure, but this could be a cause of the posterior subcapsular type. 

MEDICATION INDUCED:

Some medications that are known to cause Cataracts are:

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CONGENITAL:

It has been estimated that roughly 1 in 250 babies will be born with some form of a Cataract.  A third of them are due to unknown causes and the rest have either a genetic component or systemic health disease component.  Here are some of the most common causes:

  • Prematurity

  • Radiation exposure during pregnancy

  • Use of steroids or sulfa drugs during pregnancy

  • Trisomy 13, 15 or 21 (Down's Syndrome)

  • Diabetes

  • Aniridia (partial or complete formation of iris)

AGE RELATED CATARACTS:

It's still not entirely known why Cataracts develop later in life but it is extremely common.  Cataracts are the most common cause of visual decline in the aging populations and can be detected easily with routine eye examinations.  Within the age related Cataracts, there are a few different types:

  • NUCLEAR:

 

These are a general yellowing/opaqueness to the nucleus (middle) of the lens.  With advancing Nuclear Cataracts, you might notice blurry vision, more often in the distance and you also might have to go back to the Optometrist or Ophthalmologist for frequent eyeglasses changes.​​

 

       Why?  

       Because these types of Cataracts can actually cause more nearsightedness leading to a phenomenon known as                 "second sight" where a person who has Presbyopia and requires reading glasses becomes less dependent on them.

  • CORTICAL:

There is an area that wraps around the nucleus of the lens called the cortex.  Cortical Cataracts are opacities in this area of the lens and they can take on different shapes like whitish bicycle spokes, bubbles and water clefts.  

Increased glare symptoms and being bothered by headlights during night driving is a common symptom from this type of Cataract.  Whenever we see patients with a Cortical Cataract forming, we almost always prescribe non-glare treatment in their eyeglasses lenses.

"Bicycle - like" spokes found in Cortical Cataracts

  • POSTERIOR SUBCAPSULAR:

This is another common age related Cataract where cells migrate back towards the capsule of the lens.  These Cataracts scatter light coming in from the front of the eye and create lots of problems with glare.  

Posterior subcapsular cataracts can also be linked to Diabetes, chronic use of steroids, Iritis, and eye injuries.  

 

When getting evaluated for Cataracts, our Optometrist will check the lens structure of the eyes to assess the severity.  Just having Cataracts does not mean that any treatment is necessary. They are often progressive and the decision to get surgery will depend as much on your symptoms and visual function as it does on the signs that the doctor is able to see when viewing the eyes.

TREATMENT OF AGE RELATED CATARACTS​​

Age related Cataracts often progress slowly over several years before they become a problem for you.  Once they progress to the point where visual clarity cannot be achieved with eyeglasses or contact lenses, we will refer you to an Ophthalmologist for a surgical evaluation.  

Most of the time, age related opacities need to be removed at the same time in your life.  If you need surgery on both your eyes, the surgeon will operate on one eye, then wait another few weeks before completing the other eye.  

When the surgeon removes the Cataract, an artificial lens implant (Pseudophakia) can be inserted permanently.

Infants who need Congenital Cataracts removed will not be able to get an implant due to the fact that the eye has not finished growing yet.  Because of this, they will be left with a condition called "Aphakia" (without lens) and will need high powered convex lenses or contact lenses right away. 

Do you need a Cataract Surgeon or Ophthalmologist in Bellingham, Whatcom or Skagit County? 

 

For our patients who need surgery, we will generally refer them to one of the following eye care clinics.

Pacific Cataract & Laser Institute

Northwest Eye Surgeons ("Whatcom Eye Surgeons" in Bellingham)

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