How is a cataract formed?

Written by Peng Xi Feng
Ophthalmology
Updated on September 30, 2024
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Inside the eyeball, there is a relatively important transparent tissue called the lens. Clinically, clouding of the lens is referred to as cataracts. Many factors, such as aging, genetics, metabolic abnormalities like diabetes, trauma, radiation, poisoning, and local nutritional disorders, can lead to damage to the capsule of the lens, increasing its permeability and losing its barrier function, or causing metabolic disturbances in the lens. This can cause the proteins in the lens to denature, leading to cloudiness of the lens, which is known as cataracts. Under a slit lamp microscope, varying degrees of cloudiness in the lens can be observed.

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Ophthalmology
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Consequences of not undergoing cataract surgery

First, it is important to understand what cataracts are. Cataracts are the clouding of the lens cortex, which commonly refers to the gradual whitening of the central pupil area, the black part of the eye. Cataracts, based on their stage of development, are divided into early, middle, and late stages. In the early stage of cataract, the vision is slightly impaired. In the middle stage, the cortex becomes moderately clouded, and vision might still be around 0.4 or 0.5. In the late stage, the cataract is severely matured, generally with vision lower than 0.3. Cataract in its early and middle stages might not necessarily require immediate surgery. However, in late stages, when vision drops below 0.3, surgery should be considered. If not treated surgically, the mature cataract can completely block light, progressively decreasing vision and eventually leading to blindness. Therefore, it is advisable to consider surgical treatment for cataracts in the late stage.

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Symptoms of cataracts

The symptoms of cataracts are diverse. Firstly, the most primary manifestation is a decline in vision, which is a painless and gradual decrease. Unlike glaucoma, where the decrease in vision is accompanied by swelling pain in the eyes and even headaches, the vision decrease in cataracts occurs gradually and not suddenly. If the onset is sudden, then it is generally not considered to be caused by cataracts. Besides the painless, gradual decline in vision, some patients may experience a decrease in contrast sensitivity, and changes in refraction. For example, patients who have presbyopia might find that their presbyopia diminishes and their nearsightedness worsens if they develop cataracts, particularly nuclear cataracts. Some people may experience monocular diplopia or polyopia, as well as varying degrees of visual field defects.

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Ophthalmology
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Causes of cataracts

Various causes, such as aging, genetics, local nutritional disorders, immune and metabolic abnormalities, trauma, poisoning, radiation, etc., can lead to metabolic disorders of the lens, causing the denaturation of lens proteins and resulting in cloudiness; this is called cataract. Cataracts can be divided into congenital and acquired. Congenital cataracts, also known as developmental cataracts, are divided into anterior polar cataracts, posterior polar cataracts, nuclear cataracts, and total cataracts. Acquired cataracts are divided into senile cataracts, complicated cataracts, traumatic cataracts, metabolic cataracts, radiation cataracts, and those related to medications and poisoning.

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Cataract ou, od, os means what?

OU, OD, and OS are common descriptions in ophthalmology. OU represents both eyes, OD represents the right eye, and OS represents the left eye. These are abbreviations. For example, visual acuity for both eyes is denoted as OU, visual acuity for the left eye as OS, and visual acuity for the right eye as OD. These terms are typically used in medical records, not only to describe conditions like cataracts. For instance, the condition of cataracts in both eyes would be described as OU: OD 0.1, OS 0.3.

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Is cataract easy to treat?

If you are diagnosed with cataracts, we generally use surgical methods nowadays. Our surgical approach typically involves cataract phacoemulsification combined with the implantation of an artificial lens. If you have a simple case of cataracts without any other eye diseases—such as glaucoma, diabetic retinopathy, hypertensive retinopathy, or central retinal vein occlusion—the outcome after surgery is generally good. As for the eye drops for treating cataracts advertised on TV, like Sharp Eye Love, their effectiveness is not very certain in our medical practice. Currently, the main method of treating cataracts is still through surgery.