First Signs of Cataracts

What will I see first? That is a question I get asked every day by patients when I talk about cataracts. The patient always wants to know what are the first signs of cataracts. We talk about treatment options. We will talk about surgery. Sometimes we even talk about cataracts in dogs and what their vet said about cataracts. Funny thing though. I never hear of cats having cataracts. All these things and then more are what I am going to talk about today.

What are cataracts?

The definition of cataracts is a medical condition in which the lens of the eye becomes progressively opaque, resulting in blurred vision.

While Webster outlined it clearly I like to think of cataracts as more like a dirty car windshield. The longer that windshield goes without being cleaned the dirty and harder it is to see out of. The car windshield getting cloudier doesn’t really have much effect on our glasses prescription. While cataract progression will effect our glasses prescription slightly the analogy still holds pretty true.

What does vision look like with cataracts?

So, the thing I tell my patients are that we have a lens inside our eye kind of like a lens inside a camera. It can get dirty and I like to think of it as a dirty windshield. That is basically what we call a cataract.

What causes cataracts?

There are a few things that can cause cataracts;

  • Sunlight or UV exposure
  • Smoke exposure
  • Steroid eye drops
  • Diabetes

Now this list isn’t exhaustive and just because you have diabetes doesn’t mean that you need treatment or have cataracts right now. These are just things that can increase the progression and severity of cataracts.

Cataract Symptoms

The first signs of cataracts is usually glare at night time. Now glare at night could be a need to change glasses prescription, scratched glasses, or the fact that the individual driving your direction has LED lights. So, again just because you have glare issues at night does not mean that you need to seek out treatment. The glare could be something very simple to fix like some new glasses.

Now is there a self test for cataracts? Yes, no, but maybe. You can try by with your glasses on and one eye covered looking out into the distance in a dim room. Think only a lamp on type brightness. Have your TV on and see what all words and letters you can see. Then, turn on your cell phone light and shine it towards your eyes about 18 inches away. If with that light being shined in your eyes you can’t see hardly anything you could read before. That is a pretty good sign that you have cataracts and not just a little, but probably ready for treatment.

Types of cataracts

There are quite a few different versions or types of cataracts;

  • nuclear
  • posterior polar
  • anterior polar
  • cortical

The 3 most common types of cataracts I see in clinic are nuclear, cortical, and posterior polar.

Treatment Options

There are people that sell eye drops to remove cataracts and there are surgeons that remove them with surgery. Those are pretty much the 2 options that you will see in the world when it comes to treatment options. One of those options actually works and one is being sold on Facebook constantly.

Sadly, we do not have the technology available to remove cataracts any way other than with cataract surgery. I really wish we had other options such as eye drops, but we do not. I have had people tell me that the eye drops work, but when I look at their eyes I am told a vastly different story with what I see. The reason I wish the drops would work may surprise you, but cataracts are the leading cause of blindness worldwide. The reason is it is hard to get surgeons into those areas. Think of how simple it would be to drop ship some eye drops to a remote village and cure their blindness.

Also, I can’t sell cataract surgery in my office, but I could sell drops to remove cataracts. So, if they legitimately did work. I along with tons of other eye doctors all over the US would have these for sale. Sadly, people buy them off Facebook only to find out they are a waste of money.

Prevention is the key, but typically prevention is too late if your Eye Doctor is already talking about cataracts. The preventative steps are to wear sunglasses and stay out of smokey environments. These things help out quite a bit for kids and are less helpful as we get older, but I still recommend doing these things (not smoking and wearing sunglasses). Thankfully, years ago they stopped making sunglasses that didn’t have UV protection, because those actually increased the risk of cataracts.

Cataracts in dogs

Yes dogs do have cataracts and I do have quite a few patients that talk to me about their dogs having had cataract surgery. I have even worked with a surgeon that did cataract surgery on a liger. I don’t ever hear anything about cats getting them. The reasons dogs and ligers get them, but I never hear of cats getting them is likely due to the shape of the cats eyes. That vertical slit would reduce the amount of UV light getting to the natural lens and thus decrease the likelihood of the cat getting them.

Thank you for taking the time to read this article. Please leave a comment below and let me know if you have a topic you would like me to talk about or if you have had a cat need cataract surgery.

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Dr. Thirion

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