Symptoms of cataracts

What are cataracts?

Ever noticed how an old photograph might turn yellow or brownish with time, losing its clarity? Cataracts do something similar to our vision. They are essentially a clouding of the lens inside the eye, leading to a decrease in vision.

This lens, which sits just behind the iris (the coloured part of your eye), is made up mainly of water and protein. As we age, these proteins can begin to cluster together, forming a small area of clouding. Over time, this clouded area can grow larger, making it increasingly difficult to see clearly.

This clouding can occur in different parts of the lens, affecting vision in various ways. Some cataracts might be small and barely noticeable, while others can become so dense they can make someone virtually blind. But, as scary as that might sound, remember – with the right care and timely intervention, cataracts can often be treated successfully.

Early symptoms of cataracts

We've all had those moments – straining to read the fine print in dim lighting or finding it a little more challenging to drive at night. While these can sometimes be chalked up to fatigue or other reasons, they might also be the earliest indicators of cataracts. Understanding these subtle symptoms can make all the difference in early detection and treatment.

As we age, the clear lens in our eyes can start to become cloudy from cataracts. This cloudiness happens slowly, so you may not notice changes in your vision at first. But over time, as the cataracts grow larger, they begin to block more light from properly focusing on your retina.

This results in vision becoming progressively blurred and fuzzy. Recognising the early symptoms of cataracts is important, so you can get treatment to restore your eyesight while the cloudy patches are still small.

In the early stages, cataracts may not cause very noticeable vision problems. But some subtle changes can signal cataracts are starting to form in the periphery of your lens. Here are some of the early signs and symptoms to look out for.

Blurred vision

One of the first early symptoms of a developing cataract may be slightly blurry vision. You'll have difficulty clearly seeing text up close when you're reading or have trouble making out street signs and other objects in the distance.

Overall, your vision just won't seem as sharp as it once was - things will look a bit fuzzier and just 'off.' At first, getting a new or updated eyeglasses prescription can help sharpen your sight again. But if the blurriness persists over time, even with new glasses, it's a good idea to visit your eye doctor or optometrist for an exam. That way they can check to see if the blurriness may be caused by early cataract development.

Faded colours

As cataracts start forming, you may notice colours start to appear dull, muted and faded. The vibrancy tends to drain first from reds, purples, and blues. This happens because the cloudy areas forming on your lens block certain wavelengths of light from entering your eye.

So over time, you'll notice more colours looking increasingly washed out. If more and more hues start to appear faded or colourless, it's important to see an ophthalmologist. That way they can examine your eyes and determine if cataracts are the cause of the colour changes you're noticing.

Light sensitivity

This one's a bit counterintuitive. Increased sensitivity to bright lights is another possible early sign of cataracts. While you might struggle to see in dim light, bright lights can suddenly feel overly harsh. Glare from sunlight, car headlights at night, or indoor lamps may start to feel uncomfortably intense for your eyes. Direct sunlight or even indoor lighting might cause discomfort, leading you to squint or shield your eyes.

Some people also notice more glare and reflections when looking at computer screens or white paper. Wearing sunglasses during the day can help ease light sensitivity. But if lights continue to seem excessively glaring, talk to your ophthalmologist to discuss your symptoms.

Difficulty seeing at night

Night vision problems stand out as one of the earliest signs of cataracts. As cataracts develop, you may have more difficulty seeing clearly in low light or at night. You might find that you need more light to read or do tasks than you used to. Because your vision just isn’t as sharp, driving at night might become more challenging, especially due to the glare from oncoming headlights.

This poor night vision results from less light being able to reach your retina due to the parts of your lens that are clouding over. Let your eye doctor know if worsening night sight starts making activities like walking at dusk or driving in rain difficult.

Frequent changes in prescriptions

You might find that your glasses or contact lens prescription keeps changing at a rate that's faster than usual. This isn’t your optician trying to upsell you; it's a telling sign of the lens in your eye undergoing changes. If your eyeglass or contact lens prescription seems to require more frequent changes, developing cataracts may be the cause.

Your vision is becoming distorted from the cataract's effects, so your lenses can no longer fully compensate and correct your eyesight. Once you are over the age of 50, frequent new glasses prescriptions often indicate cataracts are present and progressively affecting your vision.

These mild symptoms arise as small cataracts first start to develop around the edges of your lens. The cloudy patches are minor, so central vision stays relatively clear. At this point, stronger glasses, sunglasses, or magnifying lenses may help compensate for the changes.

As these symptoms intensify, daily activities like reading, driving, or even recognising faces can become challenging. But with an understanding of these early signs, you can be proactive about your eye health. Remember, a regular eye exam is essential, especially if you notice any of these symptoms cropping up.

Why does your night vision suffer first?

If you've ever tried to peer through a smudged window or a foggy glass pane, you'll recognise the effect of cataracts on night vision. As cataracts begin to develop, the proteins in the lens of our eyes start to aggregate.

At night, when our pupils dilate to allow more light in, this enlarged opening means we're also taking in more of the obscured vision from the cataract-affected parts of the lens. The result? Diminished clarity during night time activities. This is particularly noticeable during tasks like driving, where the glare from other vehicles' headlights can become blinding, making night drives tricky.

Progressing cataract symptoms

As cataracts progress, so do their symptoms. That’s because without treatment, cataracts typically grow larger over time, sometimes over months and even years. While early signs might be easily dismissed or mistaken for general ageing or fatigue, the symptoms become harder to ignore.

More extensive clouding causes vision to progressively worsen meaning the early symptoms discussed in the previous section are often exacerbated . Symptoms of advancing cataracts include:

Worsening blurriness or clouded vision

As the cataract enlarges, general blurriness increasingly affects your daily activities. Reading books or signs, watching TV, and recognising faces becomes more difficult as everything looks fuzzier. Your overall sight seems even more fuzzier and ‘off’ in general.

It’s like looking through a frosty or fogged-up window. This is particularly noticeable when trying to focus on bright lights, which can appear excessively dazzling or cause a starburst effect.

Dulled colour perception

As mentioned, you may notice colours start to appear increasingly washed out and muted. The vibrancy drains from hues like blues, purples, and reds first. Colours might start to appear faded or yellowish. Eventually, all colours may take on a faded, colourless appearance. The world seems less vivid overall.

This change is because the clouded lens can act as a filter, dampening the vibrancy and clarity of colours. You might find yourself thinking that a white shirt looks off-white, or a bright red seems a touch muted.

Worsening light sensitivity

Bright sunlight, indoor lamps, and car headlights at night often cause uncomfortable glare. Your eyes have a harder time adjusting to brightness, and light sensitivity worsens over time. Excessive glare starts to make basic activities frustrating.

Poorer night vision

Seeing clearly in dim conditions becomes more challenging. Your night vision suffers, so driving after dark or walking at dusk is harder. Poor night sight results from less light penetrating your increasingly cloudy lens.

Halos and streaks

Ever noticed luminous circles around streetlights or headlights? You may begin to see halos or streaks of haze around bright lights even more. Streetlights and car headlights at night start to have glow or haziness around them. These optical effects can make driving more difficult.

These halos can appear because the diffraction of light by the cataract scatters the light entering the eye. This scattering effect can cause light sources to appear as if they have radiant halos around them.

Double vision

Seeing double images in a single eye is also possible with advanced cataracts. Imagine seeing two of everything, but only through one eye. This double vision can be temporary and might not necessarily mean the cataract is advanced, but it's a significant symptom.

This doubling effect happens when the cataract's distortion prevents light from focusing correctly on your retina.

As the clouded section expands, it obstructs more light from reaching your retina, obscuring central vision. Glasses can no longer correct the haziness. Routine tasks become frustratingly difficult. See an ophthalmologist if blurriness interferes with your lifestyle. They can evaluate your cataracts and discuss options like stronger glasses or surgery.

It's also worth noting two particular types of cataracts that show unique symptoms: nuclear and posterior subcapsular cataracts. Nuclear cataracts initially might even slightly improve vision, a phenomenon termed 'second sight'.

However, this benefit is fleeting. On the other hand, posterior subcapsular cataracts can develop quickly and can interfere with vision.

Symptoms by cataract type

Understanding the different types of cataracts is crucial. While they all result in impaired vision, each type has unique characteristics. Certain symptoms relate to the location of the cataract in your eye's lens:

Nuclear cataracts

Nuclear cataracts deep in the lens's centre cause:

• Blurry distance vision
• Needing reading material farther away
• Colours appearing faded

Beginning in the centre of the lens, nuclear cataracts are aptly named because they form in the nucleus or central zone. In its early stages, you might experience an unexpected improvement in your close-up vision, a phenomenon known as 'second sight'.

However, this temporary effect fades as the cataract progresses. Over time, the lens turns yellow or even brown, leading to a noticeable tint in vision. Reading and recognising faces become challenging tasks as the cataract further matures or grows.

Cortical cataracts

Cortical cataracts around the lens periphery cause:

• Glare sensitivity
• Shadows, patches, or streaks in vision

Cortical cataracts manifest as whitish, wedge-like opacities that start at the outer edge of the lens and work their way to the centre in a spoke-like fashion. This pattern of progression can scatter light in unusual ways, leading to the symptoms of glare and distorted vision.

Over time, these cataracts can interfere with the passage of light through the lens, causing the tell-tale shadows and patches that those affected might notice.

Posterior subcapsular cataracts

Posterior subcapsular cataracts in the back of the lens cause:

• Blurry close-up vision
• Central haziness
• Halos around lights

Forming at the back of the lens, posterior subcapsular cataracts progress more rapidly than their nuclear counterparts. Symptoms manifest quicker, often within months. Individuals with this type of cataract often find bright lights blinding. Reading, too, can become a struggle, but distant vision might remain largely unaffected in the early stages.

Congenital cataracts

• Blurry or cloudy vision
• Involuntary eye movement (Nystagmus)
• Crossed eyes or misalignment (Strabismus)

As the name suggests, congenital cataracts are present at birth. Infants with this condition have cloudiness in parts of the lens, which can affect one or both eyes. There could be multiple reasons for this, including inherited tendencies, infections during pregnancy, or trauma. It's important to detect and treat congenital cataracts early to ensure the child's visual system develops correctly.

The progression of cataract symptoms can be distressing, but the key lies in early detection and intervention. A regular check-up with an optometrist can help catch the condition in its initial stages, making treatment more straightforward and effective.

Monitoring serious symptoms of cataracts

Rarely, advanced cataracts cause urgent complications requiring swift medical care:

• Sudden increase in ‘floaters’ and flashes of light
• Shadow or curtain-like darkness spreading across vision
• Eye pain, headache, nausea signalling acute angle-closure glaucoma

These concerning symptoms indicate conditions like retinal detachment or glaucoma needing immediate treatment to prevent permanent vision loss.

Prevention and when to seek help

While age remains the most common factor for cataracts, understanding prevention methods and when to seek professional guidance is key.

Importance of regular eye exams

Just as you'd have a regular dental check-up, eye exams are vital, especially as you age. They can catch cataracts early on, making management more straightforward.

When to see a specialist?

Don’t wait for symptoms to worsen. At the first sign of vision changes, whether it's blurriness, double vision, or difficulty seeing at night, consult a specialist.

See an optometrist or ophthalmologist if cataracts are affecting your daily activities. They can evaluate your vision changes and cataract severity. Depending on symptoms, they may suggest new glasses or refer you to discuss surgery options.

Detecting cataracts early allows more time to thoughtfully consider your treatment approach. There's no need to rush into surgery, as cataracts progress slowly in most cases. Regular exams help monitor cataract development so you can pursue treatment at the appropriate time.

Suffering with cataracts symptoms?

Cataracts inevitably worsen over time without treatment. Regular eye exams help detect cataracts early while vision loss is still mild. But delaying treatment allows cataracts to progress, resulting in irreversible vision decline. Cataract surgery remains the only way to regain clear sight once cataracts have substantially formed.

If your eye doctor confirms you have cataracts, schedule follow-up exams to monitor their growth. Then you can proactively discuss surgery when blurriness begins affecting your daily routine. Stay on top of your vision health.