As we age, the term cataracts comes up more often, but what exactly are cataracts, and how can we detect them? 

To begin, cataracts develop when the lens of your eye becomes cloudy. This part of your eye is normally clear and helps you focus. The clouding that appears when cataracts develop makes it harder for light to pass through, leading to blurred or hazy vision, therefore making it harder to focus on objects or everyday activities.¹ 

As cataracts may not have any major symptoms as they start to develop, regular eye exams can aid in diagnosis and early detection, especially if there are any risk factors.¹ In this article, we will discuss the importance of regular eye exams and their role in the early detection of cataracts. 

Understanding cataracts

When a person starts to develop cataracts, there are a number of factors that can increase the risk of developing them. Ageing is the most common cause leading to cataract development, as after the age of 60, the proteins in the lens of your eye can break down and start to clump, leading to a decrease in vision.² Despite age being the most common cause of cataract development, there are also lifestyle factors or conditions that may play a significant role. These include: 

• Diabetes High levels of glucose (sugar) present in the bloodstream, especially if left uncontrolled, can lead to lens swelling or structural changes, which in turn lead to the symptoms of cataracts^2,3 
• Smoking -The chemicals in cigarettes can also damage the proteins in the lens of the eye due to oxidative stress, leading to the development of cataracts. The metal ions in cigarette smoke can also build up in the lens of smokers⁴ 
• A family history of cataracts - If you have a family history of cataracts, you may be more likely to develop them yourself. Inherited genetic mutations can affect the lens' proteins or repair mechanisms, leading to an increased risk of developing cataracts earlier. However, the exposure to environmental factors will also contribute^5,6 
• Previous eye injury or surgery - Eye injuries can cause damage to the lens, which may lead to clouding, while surgeries can disturb the natural structure of the lens and surrounding tissues⁷
• Excessive alcohol consumption - An excessive amount and prolonged time of alcohol consumption can increase the risk of developing age-related cataracts. This is because alcohol can reduce the number of nutrients available to the lens, which over time will weaken it⁸ 

The symptoms of cataracts may also be easily dismissed, but it is important to keep them in mind. These include:

• Clouded or blurred vision - similar to looking out of a misty window 
• A hard time seeing at night
• High sensitivity to light
• Frequent changes in your glasses/contact lens prescription 
• Double vision
• Seeing a ‘halo’ when you look at lights² 

Cataracts are also said to progress through 4 specific stages:

1. Early cataracts are the initial stages of a cataract where the lens of your eye is still clear, however, you start to develop difficulty focusing on objects. 
2. Immature cataracts are when the lens of your eye begins to turn opaque due to the progression of protein deposits in the centre of your eye. It is worth noting that progression to immature cataracts may take several years, although this may be accelerated by the risk factors previously mentioned. 
3. The next stage, mature cataracts, is when the cloudiness/opaqueness of your eye has spread considerably, thus affecting your vision much more. This is the stage where surgery may be suggested, which is the eventual treatment option. 
4. The last stage of progression is hypermature cataracts, where vision is severely impacted due to the cataract becoming dense. If left untreated at this stage, it could lead to further complications such as glaucoma

As mentioned previously, surgery is the most common form of treatment, where the lens is replaced with an artificial lens under an anaesthetic. However, if detected early, symptoms can be managed by wearing stronger prescription glasses, which can be of aid before surgery is needed.⁹

This highlights the importance of regular eye exams, as by visiting the ophthalmologist routinely, earlier symptoms can be detected before significant vision loss occurs. 

The role of regular eye exams

Aside from testing your visual acuity (how well you can see), regular eye exams also measure your eye health. Therefore, regular eye exams aid in ensuring eye health and early detection of cataracts. Depending on your age, the frequency of cataract eye exams differs. For example, when you're in your twenties and thirties, it is advised to have one every 5 to 10 years. Once you reach your forties, you should have one every 2-4 years and 1-3 years in your fifties. Finally, once in your sixties, it is advised to have one every year.⁹ 

The eye exam is as follows:

• A vision test is the routine check-up that you normally do when you visit the optician. This measures how well you can read letters in varying sizes
• A slit-lamp exam -also known as an eye structure exam, where the optician shines a bright light in your eye to look at the front of your eye
• A retinal exam looks at the back of your eyes, and to do so, you are normally given eye drops to dilate (widen) your pupils. Your eye may then be looked at using a slit-lamp again. 
• A fluid pressure test measures the fluid pressure in your eye

What are the benefits?

It is beneficial to have these routine check-ups as they help in the early detection of cataracts. Detecting cataracts earlier can significantly aid in the prevention of vision loss, as it can be continuously monitored. As well as this, early detection of cataracts allows you to prepare before surgery is needed, as well as allowing the patient to decide when they would like surgery. Another benefit is the reduced risk of additional complications that can arise if cataracts are left untreated for too long.¹⁰ 

Additionally, the knowledge of cataract risk factors and symptoms can also be helpful, so you are aware of what to look out for. A study in China demonstrated the importance of this, as those who were unaware of cataracts and their symptoms delayed going to the opticians and subsequently delayed treatment, leading to further complications.¹¹

FAQs

What are cataracts? 

A cataract is a cloudy area that develops in the lens of your eye, which helps you focus light. Therefore, it causes difficulty in seeing, leading to vision problems. A cataract can develop in one eye or both.¹ 

What age should I start getting checked for cataracts?

You can start getting checked for cataracts from the age of twenty, however, it is advised to start getting checks more frequently once you hit your forties.⁹

How frequently should I get a cataract eye test?

Every 10 years when you're in your 20s-30s, every 2-4 years in your 40s-50s, and every year after you hit your 60s.⁹

Summary

Cataracts develop when the eye’s lens becomes cloudy, therefore leading to blurry and clouded vision that could disrupt day-to-day activities. The most common form of cataracts is age-related. As cataracts develop without noticeable symptoms at first, it is important to get regular eye exams to detect them in their early stages before more complications may arise. Symptoms like blurred vision, increased light sensitivity, and frequent prescription changes can be subtle at first, making regular eye exams crucial. This especially applies to those with higher risk factors, which include age, diabetes, smoking, and/or family history, to name a few. Surgery is the eventual treatment for cataracts, however, early detection through regular eye exams can allow for earlier surgical intervention and preparation before significant vision loss, improved quality of life, and a reduced risk of complications. 

Although there is nothing to stop your cataracts from progressing, you can take certain measures to protect your eyes, such as wearing sunglasses/ a hat to block the sun/ UV rays, preventing eye injury by wearing protective eyewear, and eating healthy foods such as leafy greens, nuts, fruit, and vegetables.¹ 

To conclude, regular exams, tailored to age and risk factors, are essential for safeguarding eye health and cataract detection.