Cataracts are curable

TL;DR: Timely diagnosis and correct information on Cataracts will go a long way in dealing with the conditions. Here’s a bird’s eye view of cataract, its impact, types and consequences.

“Eyes wide in wonder at the world,” goes the beautiful poem. True enough, whether young or old, each one of us deserves to get a clear, unclouded window unto the world.

Who would advocate for this basic right to sight more fervently than I, Mr. Occulus, your friendly neighbourhood eye mascot for clear, healthy eyes? After all, 80 per cent of all sensory perception happens through the eyes.

In a sentence: what exactly is Cataract or Motibindu as it is called in Hindi and Marathi? And why should it matter to us?

Cataract: The cloudy lens that clogs the view

Let’s think of our two eyes as an open window that allows us a clear view of the scenery. We can see everything clearly.

Bit by bit, though, the picture starts to get foggy. Initially, the fog is negligible, but it grows and grows, until you can see nothing but the fog.

This, in a nutshell, is what cataracts do to your eyes.

Like the fog, they sweep in quietly, develop gradually and initially do not merit undue alarm. But as time passes,you will find it gets more difficult to see, read, sew, cook, paint a picture or even make out the expression on another person’s face in the course of a conversation.


Symptoms differ from patient to patient. While the picture could get hazy and blurred for some, others could experience lights that feel way too bright or glaring with a surrounding halo. On the other hand, some would report poor night vision or multiple/double vision. Still others could experience increased nearsightedness and distortion of vision in either eye. 

Sure, eyeglasses and better lighting can help you see better. But if the condition progresses, you might need surgical intervention.

Cataract is not a disease. It’s a condition caused by age and is 100% treatable

Before you get too worried, dear reader, let me tell you that Cataracts are an eye  condition with safe, effective treatment options. Timely diagnosis, a willingness to seek medical help and getting over certain myths are key, though!

However, before we get to solving it, we need to fully appreciate the issue in its entirety. 

Blight on your sight: The figures say it all.

As per the National Blindness and Visual Impairment Survey India (2015-19) conducted by the Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, at the behest of the Union Ministry of Health and Family Welfare, cataract is the numero uno cause of blindness in folks above 50 years. The breakup says Cataract is responsible for 66.2 per cent of total blindness, 80.7 per cent severe visual impairment and 70.2 per cent moderate impairment in just this age group.

What makes this all the more regrettable is that over 90 per cent of the cases of blindness as well as severe visual damage were avoidable and more than half, easily treatable.

It isn’t as if the picture is prettier for the younger lot either! Cataract impacts 15 out of every 10, 000 babies in India.

The contributing causes: Age is the first and foremost reason in developing cataracts. Unsurprisingly, lifestyle issues like smoking, steroid and diuretic use, use of major tranquilizers and excessive exposure to sunlight are to blame. As are diseases like diabetes. Sometimes, cataracts arise as a result of over-exposure to radiation such as X-rays, microwaves etc. Ultraviolet light is known to cause cataracts so investing in a good pair of sunglasses is wise!

While genetics are responsible in some cases, the presence of cataracts in childhood or early life can occasionally be due to a particular syndrome. Besides this, those with certain skin conditions like atopic dermatitis and eczema, ichthyosis, basal cell nevus and pemphigus occasionally develop shield shaped cataracts.

Low vitamin C intake and serum levels are also linked to higher instances of cataract.

Research is ongoing to investigate the causes further.

Poverty and blindness: why breaking the cycle is so important

It’s an open secret that poverty and blindness co-exist in a vicious cycle. Since they are poor, the blindness remains untreated (lack of literacy, awareness and access), and since they are blind, they continue to stay poor. Everybody loses, nobody wins!

Unsurprisingly, over 90 per cent of the world’s blind live in poor countries-of which the main cause, as mentioned, frequently is cataracts, said to affect 95 million worldwide.

On the positive side though, research shows that a person’s earning potential could go up by as much as 1500 per cent  and we aren’t even accounting for the happiness, restoration of self-esteem and improved quality of life.

Here’s a detailed look at the main types of Cataracts:

Cataracts by groups

• Age-related cataract: Everyone over the age of 40 is at risk-though age-related cataracts typically show up after 65, in one or both the eyes.
  
  
• Congenital cataracts: Some babies are born with them, while others develop them as they grow, in one or both the eyes.
  
  
•  Trauma Cataract: As the name suggests, eyes that have been injured may develop a cataract soon/gradually after the accident.
  
  
• Secondary Cataract: This happens as a consequence of another major disease, for instance, diabetes or a lifestyle issue such as taking steroids.
  
  
• Radiation Cataract: Admittedly, this is a rare occurrence, but it is possible that exposure to certain types of radiation and ultraviolet light from the sun could cause cataracts.  

Cataracts by location on the Eye lens

As per the American Academy of Opthalmology, the division as per the location of the cataract on the eye lens, is as follows:

Nuclear Cataract: It is the most common type of cataract, associated with ageing. The changes in vision are gradual. Nuclear cataracts occur in the centre of the lens and lead to myopia or nearsightedness.

Cortical Cataract: As the name suggests, a cortical cataract appears as a cloudy opacity in the cortex of the eye or the periphery of the lens. Typically, the patient develops wedge-shaped spokes in the eye that stretch outside-inside, from the outside of the lens to the centre. Naturally, this would mean interference with the transmission of light and cause glare and loss of contrast. This condition usually happens to people who have diabetes and can hamper both distance and near vision-so it’s wise to treat this early on.

Posterior Subcapsular cataract (also called PSC):  This starts as a small opacity at the back of the eye lens, right in the path of light. This type of cataract is slow to develop and is usually noticed when the cataract is well-developed for that’s when the symptoms start to show! Those at risk include people with myopia, diabetes, retinitis pigmentosa, and those taking steroids. This condition is the main culprit behind your diminishing reading vision, glares and halos at nights. Though the deterioration is faster than other types of cataracts, advancements in treatment make them treatable.

Christmas Tree Cataract: It is a rare condition and is characterised by needle shaped crisscrossing the deep cortex and nucleus of the lens. The refractive, colourful nature of the cataract makes it look like coloured lights on the branches of a Christmas tree.

These are the different kinds of cataracts to watch out for. But now that we have defined the problem, we are in a position to zero in on the solution. Fortunately, they are well within reach and will ensure your eyes continue to be a clear window!

In the next blog, I will walk you through the existential question on each cataract-affected person’s mind: to operate or not to operate!

 Reference: Assorted medical journals, websites and news sources