Understanding Cataracts: Expert explains causes, symptoms, and treatment

Cataracts are a leading cause of vision impairment, yet many people fail to recognize their early signs. Dr. Andrew Mugisha, an ophthalmologist at St. George Eye Clinic, explains what cataracts are, how they develop, and the treatment options available to restore clear vision.

The lens of the eye, located just behind the iris, functions like a camera lens by focusing light onto the retina to create sharp images. Cataracts form when proteins in the lens break down and clump together, leading to cloudiness and progressively worsening vision. While cataracts typically develop in both eyes, they do not necessarily progress at the same rate.

Dr. Mugisha notes that cataracts are often an inevitable part of aging. Most people over the age of 55 experience some degree of cataract formation, and by the age of 80, half of Ugandans either have cataracts or have undergone cataract surgery. However, aging is not the only cause. Conditions such as diabetes, high blood pressure, and obesity increase the risk, as do lifestyle factors like smoking, excessive alcohol consumption, and prolonged exposure to radiation. A family history of cataracts can also predispose individuals to the condition.

“Many patients don’t realize they have cataracts until they start struggling with everyday activities like reading or driving at night,” says Dr. Mugisha. “It’s important to get regular eye check-ups because early detection allows us to monitor the progression and determine the best time for surgery.”

Symptoms of cataracts include blurry or cloudy vision, increased sensitivity to light, difficulty seeing at night, and trouble reading or performing tasks in dim lighting. Some individuals experience halos around lights, dullness in colors, or frequent changes in their eyeglass prescriptions. In severe cases, cataracts can lead to double vision in one eye.

When cataracts begin to interfere with daily life, surgical intervention is the most effective treatment. Dr. Mugisha explains that cataract surgery is a straightforward outpatient procedure that allows patients to return home the same day. The operation involves removing the clouded lens and replacing it with an artificial intraocular lens, restoring clear vision. Patients typically resume normal activities within a few days.

One of the major benefits of cataract surgery is the significant improvement in quality of life. Blurred vision often forces individuals to limit activities such as driving or engaging in hobbies, which can lead to frustration, anxiety, and even depression. Research suggests that cataract surgery enhances quality of life by at least 35% and reduces the risk of falls and fractures, particularly in older adults.

“Cataract surgery is life-changing,” Dr. Mugisha emphasizes. “Many patients tell us that after surgery, they can do things they hadn’t been able to do in years. The difference in vision is almost immediate for most people.”

Ideal candidates for cataract surgery are those who struggle with vision clarity and find it difficult to perform everyday tasks. In some cases, insurance requirements may influence the timing of surgery, but patients can opt for the procedure whenever they feel it is necessary to enhance their quality of life.

During the surgery, doctors can implant different types of lenses depending on the patient’s needs. Some lenses correct both near and distance vision, reducing reliance on glasses. For patients with astigmatism, toric lens implants offer improved distance vision without additional corrective lenses. Monofocal lens implants, on the other hand, enhance clarity for night vision and low-contrast environments like rainy or dimly lit conditions.

Dr. Mugisha highlights that while cataract surgery is highly effective, about 20% of patients experience cloudiness in the capsule that holds the new lens. In such cases, a simple YAG laser procedure can be performed to restore clear vision.

Recovery from cataract surgery is generally smooth, with most patients experiencing improved vision within days or weeks. Post-surgery care includes wearing protective eyewear, avoiding strenuous activities, and using prescribed eye drops to prevent infection. A follow-up visit ensures proper healing and assesses the need for additional vision correction.

With advancements in intraocular lens technology, patients can expect sharper vision and minimal dependence on prescription glasses after surgery. Dr. Mugisha emphasizes the importance of regular eye check-ups to detect cataracts early and maintain good eye health. “If you notice changes in your vision, don’t wait. Cataract surgery is safe and effective, and it can drastically improve your quality of life,” he advises.