Cataracts

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Cataracts

A cataract is a clouding of the eye's lens that causes a gradual loss of vision. Normally, light passes through the lens (clear tissue behind the pupil), and gets focused on the retina, the eye's light-sensitive layer that sends visual signals to the brain. To produce a sharp image, the lens must remain clear.

Signs and Symptoms

There are some easy-to-recognize signs and symptoms of cataract, including those described below.

	Decreased or blurred vision (often described as a "fog")
	Double vision
	Colored halo around lights
	"Second sight," where a patient who normally wears reading glasses can suddenly read without them
	Brown spots in the visual field

What Causes It?

Aging is the most common cause of cataracts, which most often occur in people over 50 years of age.

Who's Most At Risk?

Cataracts are classified according to the types of people most likely to develop them.

	Age-related cataract: Most cataracts are related to aging.
	Congenital cataract: Some people are born with cataracts or develop them in childhood, often in both eyes. These cataracts, however, may not affect vision.
	Secondary cataract: These are cataracts that develop in people with certain other health problems, such as diabetes. Cataracts are also sometimes linked to steroid use.
	Traumatic cataract: Cataracts can develop following an eye injury, either soon after or years later.

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with cataracts, you should see an eye care professional. He or she can make a diagnosis and help guide you in determining which treatment or combination of therapies will work best for you.

To detect a cataract, your eye care professional will examine the lens, using the following tests:

	Visual acuity test, which measures how well you see at various distances
	Pupil dilation, in which the pupil is widened with eye drops to reveal more of the lens and retina
	Tonometry, which measures fluid pressure inside the eye

Treatment Options

Prevention

Drugs are available that may delay cataract formation, especially in patients with diabetes or other conditions that predispose them to cataracts. However, no known drugs are available to reverse the progression of cataracts once they form. Using UV-blocking sunglasses may help prevent cataracts.

Drug Therapies

Your eye care professional may prescribe eye drops, to dilate the pupil to provide better vision.

Surgical and Other Procedures

If you have a cataract in the early stages, you may be able to improve your vision by using different eyeglasses, magnifying lenses, or stronger lighting. If these measures don't help and your vision loss interferes with your everyday activities, such as driving, reading, or watching TV, surgery is the only effective treatment. During surgery, the surgeon removes the cloudy lens and replaces it with a substitute lens. Cataract removal is one of the most common operations performed today.

Your eye care professional may also recommend removing a cataract if you have certain eye diseases, if the cataract threatens to cause another eye disease, or if the presence of the cataract prevents examination or treatment of another eye problem.

Complementary and Alternative Therapies

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

Nutrition

	Increase consumption of antioxidants, which have been shown to counteract processes resulting in disease. Dark leafy greens, orange and yellow vegetables, vitamins A (10,000 IU a day) and C (500 to 1,000 mg two to three times a day), and beta-carotene (50,000 IU a day) are good sources of antioxidants.
	Eat dark berries, particularly blueberries, to help protect the lens.
	Use a glutathionine supplement (200 mg twice daily) to protect against UV light.
	Use vitamin E (400 IU a day) to protect against free radical damage (cell damage that occurs as part of the aging process).

Herbs

The following herbs may help protect the lens.

	Dusty miller (Cineraria maritima) succus (preserved plant juice): one to three drops twice daily in affected eye; may cause eye irritation.
	Bilberry (Vaccinium myrtillus): 200 mg twice a day
	Ginkgo biloba: 160 mg twice a day

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction). Dose for teas is one heaping teaspoon herb/cup water steeped for 10 minutes (roots need 20 minutes).

Homeopathy

An experienced homeopath can prescribe a regimen for treating cataracts that is designed especially for you. A homeopathic remedy may address the causes of cataract formation and slow its progression.

Physical Medicine

Contrast hydrotherapy—alternating hot and cold water applications to the face or back of neck—may improve circulation to the head and facilitate the transport of nutrients to the eye. Alternate three minutes hot with one minute cold and repeat three times for one set. Do two to three sets per day.

Prognosis/Possible Complications

Nearly 95 percent of patients who have cataract surgery experience improved vision almost immediately. Complications from surgery are rare, but they can occur. These include infection, bleeding, inflammation (pain, redness, swelling), loss of vision, or light flashes. With prompt medical attention, such problems usually can be treated successfully. Cataract surgery also predisposes individuals to retinal detachment (a hole or tear in the retina, or when part of the retinal layer is pulled away).

Following Up

You may need to take eye drops or pills to help healing and control the pressure inside your eye for a few days after surgery. You'll also wear an eye shield or eyeglasses. Your health care provider will schedule eye exams as needed to check on your progress.

Supporting Research

Bartlett JO, Jaanus SD. Clinical Ocular Pharmacology. 2nd ed. Boston, Mass: Butterworths; 1989:807-808, 414-416, 630.

Branch WT Jr. Office Practice of Medicine. 3rd ed. Philadelphia, Pa: W.B. Saunders; 1994:584, 866-867.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:168, 2208, 2558.

Fraunfelder FT, et al. Current Ocular Therapy. No. 3. Philadelphia, Pa: W.B. Saunders; 1990:613-618.

Murray MT, Pizzorno JE. Encyclopedia of Natural Medicine. Rocklin, Calif: Prima Publishing; 1998:193-196.

Newell FW. Ophthalmology: Principles and Concepts. St. Louis, Mo: Mosby; 1996:369-378, 516.

Wyngaarden JB, et al. Cecil Textbook of Medicine. 19th ed. Philadelphia, Pa: W.B. Saunders; 1992: 1077, 1308, 2270, 2358.

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.