Cataracts

Signs and Symptoms

• Decreased or blurred vision, often described as a fog
• Double vision
• Halo around lights
• "Second sight." When a person who normally wears reading glasses can suddenly read without them.
• Brown spots in the visual field

What Causes it?

A cataract develops when protein in the lens clumps together and blocks light from reaching the retina. Researchers do not know what causes these proteins to clump together. But some think that cataracts may develop due to chemical changes in the lens that happen as people get older. Other researchers believe that there may be several causes of cataracts, including smoking, diabetes, and excessive exposure to sunlight.

There are four different types of cataracts.

• Age-related cataracts
• Congenital cataracts that are present at birth or develop in early childhood, usually in both eyes
• Secondary cataracts that develop in people with medical conditions (such as diabetes) or in those who use steroids
• Traumatic cataracts that develop as a result of an eye injury

Who is Most at Risk?

The following factors may increase a person's risk for developing cataracts:

• Being older than 50
• Being a woman
• Genetic diseases, such as Down syndrome
• Certain medications, such as steroids
• An infection, such as rubella, during pregnancy
• Taking drugs during pregnancy
• Radiation therapy during pregnancy
• HIV
• Celiac disease
• Metabolic disorders, such as diabetes
• Eye disorders, such as glaucoma
• High-voltage electrical injury
• Smoking
• Excessive exposure to sunlight
• Elevated body mass index (BMI)

What to Expect at Your Doctor's Office

If you have symptoms of cataracts, you should see an eye care professional. The eye care provider can make a diagnosis and help determine which treatments are right for you.

Eye care professionals can detect cataracts with the following tests:

• Visual acuity test. Measures vision at various distances.
• Pupil dilation. The pupil is widened with eye drops to reveal more of the lens and retina.
• Tonometry. Measures fluid pressure inside the eye.

Treatment Options

To avoid developing cataracts wear UV-blocking sunglasses and do not smoke.

Some medications may help delay cataracts from forming, particularly if you have diabetes or other high-risk conditions. But none can reverse the progression of cataracts once they form.

• Eye drops containing phenylephrine and homatropine may be prescribed to dilate the pupil and provide better vision.
• Aldose reductase inhibitors may help prevent or delay cataracts in people with diabetes.
• Antibiotics and steroid eye drops may be prescribed after cataract surgery.

In its early stages, a cataract usually does not cause vision loss. However, over time, a cataract may grow larger and cloud over more of the lens, making it difficult to see.

When cataracts cause vision loss that interferes with everyday activities, such as driving, reading, or watching television, surgery is the only effective treatment. During surgery, the cloudy lens is replaced with a substitute lens.

Your doctor may also recommend having cataract surgery if:

• You have other eye conditions
• The cataract threatens to cause another eye disorder
• The cataract prevents examination or treatment for another eye problem

A comprehensive treatment plan for cataracts may include a range of complementary and alternative therapies.

While there are no supplements that will improve cataracts once you have them, eating more antioxidant-rich foods may help you maintain good eye health. Try green, leafy vegetables, peppers, cherries, and berries, such as blueberries, blackberries, and raspberries. Berries contain high levels of beneficial antioxidants for eye health.

Eating fish may help prevent cataracts. In one study, researchers found that women who ate fish 3 times a week rather than once a month lowered their risk of cataracts by 11%.

There has been some study of antioxidants in the diet, too. In one study, researchers found that higher dietary intakes of lutein (found in green vegetables, egg yolks, squash, corn, grapes, and orange juice) and vitamin E from food and supplements significantly reduced the risk of cataracts during the 10-year study period. However, there is no proof that taking these nutrients in supplement form will help. In fact, one study found that high-dose vitamin C and high-dose vitamin E increased the risk of age-related cataracts.

In another study, people who ate more foods with protein, niacin, thiamin, riboflavin, and vitamin A had fewer cataracts than those who ate less of these nutrients. Niacin, thiamin, and riboflavin are B vitamins. Again, the study looked at people who got the nutrients through food. Researchers do not know whether taking any of these vitamins as a supplement would help reduce the risk of cataracts.

The use of herbs is a time-honored approach to strengthening the body and treating disease. However, herbs can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care practitioner.

You may use herbs as dried extracts (capsules, powders, or teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. of herbs per cup of hot water. Steep for 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination.

Bilberry (Vaccinium myrtillus) standardized extract, 80 mg, 2 to 3 times daily, is an antioxidant that has been used traditionally to reduce the risk of cataracts. However, more studies are needed to determine whether it is safe and effective. Bilberry may increase the risk of bleeding, especially if you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin. Bilberry may also lower blood sugar. So people who take diabetes medications should ask their doctor before taking bilberry. People with low blood pressure, heart disease, or blood clots should not take bilberry. DO NOT take bilberry if you are pregnant or breastfeeding.

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider certain remedies for the treatment of cataracts based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account your constitutional type, includes your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.

Prognosis/Possible Complications

Complications from surgery are rare. But they can include:

• Infection
• Bleeding
• Retinal detachment
• Inflammation (pain, redness, swelling)
• Loss of vision
• Light flashes

With prompt medical attention, such problems can usually be treated successfully. Preliminary studies suggest that early-onset cataracts is associated with an increased risk of cancer in subsequent years.

Following Up

A doctor may prescribe eye drops or medications to help healing and control the pressure inside the eye for a few days following surgery. You may need to wear an eye shield or eyeglasses. A doctor will schedule eye exams as needed to check on progress.

Supporting Research

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