Cataracts

Cataracts are clumps of protein that collect on the lens of the eye and interfere with vision. Normally light passes through the lens, the clear tissue behind the pupil, and focuses on the retina. The retina is the light-sensitive layer of the eye that sends visual signals to the brain. A cataract happens when the clear lens becomes cloudy.

Most cataracts develop slowly over time and are a natural result of aging. Once cataracts become large enough that vision loss interferes with everyday activities, such as driving, reading, or watching television, they should be surgically removed.

Cataract removal is one of the most common operations performed in the United States. According to the National Eye Institute, roughly 90% of people who have cataract surgery have better vision afterward.

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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

Prevention

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.

Drug Therapies

• 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.

Surgical and Other Procedures

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

Complementary and Alternative Therapies

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

Nutrition and Supplements

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.

Herbs

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.

Homeopathy

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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Casparis H, Lindsley K, Bressler NB. Surgery for cataracts in people with age-related macular degneration. Cohrane Database Syst Rev. 2009;(1):CD006757.

Chan AW, Ho YS, Chung SK, Chung SS. Synergistic effect of osmotic and oxidative stress in slow-developing cataract formation. Exp Eye Res. 2008;87(5):454-61.

Chiang CC, Lin CL, Peng CL, Sung FC, Tsai YY. Increased risk of cancer in patients with early-onset cataracts: a nationwide population-based study. Cancer Sci. 2014; 105(4):431-6.

Christen WG, Liu S, Glynn RJ, Gaziano JM, Buring JE. Dietary carotenoids, vitamins C and E, and risk of cataract in women: a prospective study. Arch Ophthalmol. 2008;126(1):102-9.

Cumming RG, Mitchell P, Smith W. Diet and cataract: the Blue Mountains Eye Study. Ophthalmology. 2000;10:450-6.

Fontani G, Corradeschi F, Felici A, et al. Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects. Eur J Clin Invest. 2005;35(11):691-9.

Ghaem Maralani H, Tai BC, Wong TY, et al. Metabolic syndrome and risk of age-related cataract over time: an analysis of interval-censored data using a random-effects model. Invest Ophthalmol Vis Sci. 2013; 54(1):641-6.

Granado F, Olmedilla B, Blanco I. Nutritional and clinical relevance of lutein in human health. Br J Nutr. 2003;90(3):487-502.

Head KA. Natural therapies for ocular disorders, part two: cataracts and glaucoma. Altern Med Rev. 2001;6(2):141-66.

Jacques PF, Taylor A, Moeller S, et al. Long-term nutrient intake and 5-year change in nuclear lens opacities. Arch Ophthalmol. 2005;123:517-26.

Kang JH, Pasquale LR, Willett W, et al. Antioxidant intake and primary open-angle glaucoma: a prospective study. Am J Epidemiol. 2003;158(4):337-46.

Lu M, Cho E, Taylor A, et al. Prospective study of dietary fat and risk of cataract extraction among US women. Am J Epidemiol. 2005;161(10):948-59.

Mody VC Jr, Kakar M, Elfving A, et al. Ascorbate in the rat lens: dependence on dietary intake. Ophthalmic Res. 2005;37(3):142-9. Epub 2005 May 3.

Mollazadegan K, Kugelberg M, Lindblad BE, Ludvigsson JF. Increased risk of cataract among 28,000 patients with celiac disease. Am J Epidemiol. 2011;174(2):195-202.

Rasmussen LD, Kessel L, Molander LD, et al. Risk of cataract surgery in HIV-infected individuals: a Danish nationwide Population-based cohort study. Clin Infect Dis. 2011;53(11):1156-63.

Renzi LM, Johnson EJ. Lutein and age-related ocular disorders in the older adult: a review. J Nutr Elder. 2007;26(3-4):139-57.

Rotsein OD. Oxidants and antioxidant therapy. Crit Care Clin. 2001;17(1):239-47.

Santosa S, Jones PJ. Oxidative stress in ocular disease: does lutein play a protective role? CMAJ. 2005;173(8):861-2.

Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002;21(6):495-505.

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West AL, Oren GA, Moroi SE. Evidence for the use of nutritional supplements and herbal medicines in common eye diseases. Am J Ophthalmol. 2006;141(1):157-66.

Ye J, He J, Wang C, et al. Smoking and risk of age-related cataract: a meta-analysis. Invest Ophthalmol Vis Sci. 2012; 53(7):3885-95.

Ye J, Lou LX, He JJ, Xu YF. Body mass indez and risk of age-related cataracts: a meta-analysis of propective cohort studies. PLoS One. 2014; 9(2):e89923.

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Zheng Selin J, Rautiainen S, Lindblad BE, Morgenstern R, Wolk A. High-dose supplements of vitamins C and E, low-dose multivitamins, and the risk of age-related cataract: a population-based prospective cohort study of men. Am J Epidemiol. 2013;177(6):548-55.

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Review Date: 9/29/2015  

Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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