The Different Types of Cataracts
Cataracts are a very common ocular (eye) problem. They are most commonly found in the elderly and cause the vision to become blurred, hazy, and/or foggy. They also create glare at night making it difficult to drive and can even effect color perception and contrast sensitivity. Unfortunately, cataracts are not limited to the elderly.
What Exactly is a Cataract?
Between the iris (the color part of the eye) and the vitreous is the lens. This structure is densely packed with cells that are contained inside a bag known as a capsule.
The center of the lens is called the nucleus and as the lens grows, it constantly produces new fibers. The old fibers are pushed toward the center of the lens, and form the nucleus. Think of it as an onion. As you peel off the layers of the onion they get smaller and tighter. The same is true of the lens; it just doesn’t smell as bad.
Anatomy of the Lens
The capsule is suspended by little filaments called zonules that are attached to the ciliary body, a muscle that produces aqueous. These filaments allow the lens to bend and flex in order to focus on objects at different distances. This is how we are able to read and see things like our dashboard when we’re driving.
Anatomy of the Lens and Surrounding Structures
Typically as we age, the lens begins to harden which causes a number of different symptoms including:
- Blurry/hazy/foggy vision
- Inability to read at close range
- Difficulty seeing a computer screen or vehicle dashboard
- Problems with contrast sensitivity
- Glare from lights (both headlights and traditional lighting)
- Problems driving at night
- Vision that seems dim, or dark
- Changes in color perception
These symptoms typically come on gradually, and the patient may not notice them until the cataract makes a significant impact on their daily activities.
Dr. Thomas Kropp Explains Cataract Surgery
Like its name suggests, traumatic cataracts are typically caused by trauma. This can be a blow to the head, or a blunt injury to the eye such as getting hit in the eye with a tennis ball.
Blunt trauma, specifically to the globe (eyeball) is the most common form of injury to cause this type of cataract, although lacerations and foreign bodies can also trigger this reaction. Blunt trauma to the orbit (eye socket) can also trigger a traumatic cataract.
Dr. Kevin Barber Performs Cataract Surgery
These types of cataracts typically form rapidly, but there are rare cases in which they form more slowly. Symptoms of traumatic cataracts include:
- Sudden loss of vision
- Sudden appearance of hazy or cloudy vision
- Sudden onset of glare at night while driving
- Sudden onset of glare from sunlight
- Sensation of an obstruction in the vision
Treatment for traumatic cataracts is the same as for any other cataract. Surgery to remove the cataract is performed and then an intraocular lens is implanted. The only difference is that the traumatic cataract is much more difficult to remove. They are very hard and because of this, in most cases traditional phacoemulsification (the process of using ultrasonic waves to break up the lens) can’t be used. This requires that the lens be removed in one piece, which means a larger incision and more healing time.
This type of cataract is present at the time of birth and is usually the result of one of the following birth defects:
- Down syndrome (trisomy 21)
- Ectodermal dysplasia syndrome
- Conradi syndrome
- Congenital rubella
- Chondrodysplasia syndrome
- Familial congenital cataracts
- Lowe syndrome
- Hallerman-Streiff syndrome
- Trisomy 13
- Marinesco-Sjogren syndrome
- Pierre-Robin syndrome
Like traumatic cataracts, congenital cataracts are difficult to remove. Intraocular implants are not typically used in infants, and this requires that contact lenses be worn to facilitate visual development. If one eye is weaker than the other, the stronger eye may need to be patched to prevent amblyopia (lazy eye).
Other Causes of Cataracts
Cataracts can also be caused by a number of environmental factors. These are very similar to senile cataracts because the typically form very slowly. There are a number of medications that can trigger cataracts including:
- Steroids such as Prednisone or Kenalog (triamcinolone)
- Cholesterol lowering medications such as the statin class (Lipitor, Zocor)
- Antipsychotics such as Thorazine
- Chemotherapy medications such as Busulfan
While cataracts can’t be prevented completely, there are steps you can take to minimize your risk of getting them prematurely.
One of the most important of these is to always wear safety glasses. Whether you’re just playing tennis, or using power tools, it’s best to wear some type of protective eyewear to prevent anything from hitting you in the eye. This will reduce the risk of triggering a traumatic cataract and will also prevent the cornea from becoming injured and possibly scarring.
Other things you can to do help prevent premature cataracts include:
- Take plenty of vitamin C – it won’t hurt you, and any excess that you take will be excreted through the kidneys (but you’ll get a bad case of diarrhea before that happens). Vitamin C is necessary for the production of collagen, which is the main protein that makes up the lens. It’s also a very potent antioxidant and helps to promote phagocytosis, or the removal of cellular “trash.” This will help prevent any excess cellular debris from building up in the layers of the lens.
- Eat a healthy diet - this means plenty of leafy green vegetables and try to minimize your consumption of meat and dairy products, especially red meat. Meat and dairy tend to create more free radicals than vegetables and organic whole grains, and free radicals lead to more cellular debris.
- Eat only organic food – try to stay away from packaged foods and items that contain preservatives.
- Avoid Sugar – Sugar causes spikes in blood sugar which cause the lens of the eye to age faster (along with everything else). Try to avoid adding sugar to beverages and eating processed foods with added sugars. Stick to a whole foods diet. If it comes from a box, don't eat it.
- Get plenty of exercise – the increased heart rate produced from exercise makes the immune cells travel through the blood stream faster and this facilitates the removal of free radicals and other cellular debris.
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