A cataract is the clouding of the eye lens—the normally clear part of the eye that focuses light to create an image on your retina, allowing you to see. The clouding is caused by a natural breakdown in proteins in the lens, which then clump together and make your field of vision cloudy or blurry.
Cataracts can occur in one or both eyes, and they are the leading cause of vision loss in the U.S., affecting more than 20 million adults over age 40. They may progress quickly, causing noticeably dimmer, hazier vision. But often they develop so slowly that it can take years to become aware of vision changes. If left untreated, cataracts can cloud so much of the eye they ultimately cause blindness. They’re also the leading cause of vision loss worldwide.
What causes cataracts?
Not everyone develops cataracts, but they are considered a normal part of getting older, says Rajesh K. Rajpal, M.D., Chief Medical Officer, Vision, Johnson & Johnson. The gradual clouding of the lens starts at birth, he says, but typically doesn’t cause problems until a person reaches their 50s, 60s or 70s.
Aside from age, risk factors for cataracts include excess sun exposure, a family history of cataracts and certain health conditions such as diabetes, according to the National Eye Institute.
Common cataract symptoms
When a cataract forms, you’ll likely start to experience blurriness and less tolerance to bright lights. Colors may not look as vibrant as they once did, and the words or images on screens might seem dimmer or as if you’re viewing them through a fogged window. As the cataract develops and the lens gets cloudier, these symptoms become more pronounced.
“Patients will often notice glare, halos or starbursts on or around lights, causing reading and night driving to become difficult,” says Dr. Rajpal. Eventually, it may become difficult to drive or read at all.
Improving vision impacted by early-stage cataracts
“As vision changes, patients should have an evaluation by their eye doctor,” says Dr. Rajpal, especially since some of the symptoms of cataracts are similar to those of more serious eye conditions. During a dilated eye exam, an ophthalmologist will be able to confirm the presence of cataracts while ruling out other potential issues.
If a cataract is present but isn’t causing significant difficulty reading, driving or doing any other day-to-day activity, certain measures can help—such as changing your glasses prescription, using magnifying lenses and relying on more focused lights when reading and viewing screens, he says.
What to know about cataract removal surgery
“When patients decide they’re at the stage where they can’t do what they enjoy—like driving, reading or watching TV—we start to think about cataract surgery,” says Dr. Rajpal. Cataract removal surgery is the most commonly performed surgery in the world, he adds, with 3.7 million surgeries performed each year in the United States and 20 million worldwide.
During this outpatient procedure, a patient is given eye drops to dilate the pupil, as well as medication that numbs the entire eye and surrounding area. A sedative that causes sleepiness and ensures the patient is relaxed and comfortable is then administered.
The most common method of the actual surgery is referred to as small incision cataract surgery. With this procedure, the surgeon makes a small incision in the corner of the eye. Next, a small probe emits ultrasound waves to break apart the nucleus, which is the hard center of the clouded lens. The rest of the cataract is then removed through the incision, using a suction probe. In some cases, a laser is also used to assist in the surgical procedure.
Once the natural lens is removed, the surgeon replaces it with an artificial lens implant—called an intraocular lens, or IOL—in the space where the natural lens once was. The procedure alone takes 10 to 15 minutes, and the total time from going into surgery and to recovery is typically less than an hour.
“The visual recovery is typically fairly rapid,” says Dr. Rajpal. “By the next day, there’s usually improvement.” Vision continues to get better over the next several weeks, he says. Because the IOL is artificial, it isn’t possible for a cataract to form again.
Cataract surgery has a high success rate, with 96% of patients reporting improved vision, according to a survey published in BMJ Open Ophthalmology. Some people experience short-term postsurgical side effects, such as grittiness, blurry vision or light sensitivity. But the procedure is considered safe and serious complications are rare, according to the American Academy of Ophthalmology.
Innovating in intraocular lenses
Johnson & Johnson has long been committed to developing IOLs that restore vision to patients who undergo cataract surgery. Recently introduced in the U.S. is the TECNIS Odyssey IOL, an intraocular lens that offers patients the possibility of a continuous full vision range, minimizing their need for glasses. Astigmatism can also be corrected during cataract surgery with specialized IOLs or by using a laser.
Before opting to have cataract surgery, Dr. Rajpal recommends that patients talk to their doctor about their goals for their eyesight—in other words, if they want an IOL that specifically restores distance, intermediate or near vision or a combination. That open communication can help determine the best IOL for a patient’s individual needs.
