As we get older, cataracts become a problem experienced by a great number of people just like you. Cataracts are a common cause of vision problems among people in their 50’s and 60’s and they are actually a major cause of senior eye problems and vision loss. According to the National Eye Institute (NEI), more than 20 million Americans age 40 and older have cataracts and more than half of all Americans develop cataracts by age 80. A cataract is a clouding of the crystalline lens of the eye preventing light rays from passing through it easily. This results in a clouding and blurring of vision. For many patients, cataracts start out slowly and have little effect on vision at first. But, as the cataract becomes denser, so does the impact on vision.
Cataracts can affect us even if we have had normal vision all our lives. It is important to note that cataracts are even more common if we have had certain health problems, such as diabetes, or taken certain medications such as cortisone for asthma or other types of inflammatory conditions.
Further, you are more prone to developing cataracts if you are a smoker or if you have spent considerable time in direct sunlight without the help of UV protecting eyeglasses or sunglasses.
If you are experiencing vision changes like these, it is important to schedule a comprehensive eye exam and cataract evaluation at D’Ambrosio Eye Care.
When we are younger, the crystalline lens is usually “crystal clear” and has excellent transparency and optical clarity. As we progress through our 50’s, 60’s, and beyond, the normally “crystal clear” lens may gradually become yellow and cloudy. When this occurs, you may initially experience a mild blurring of your vision and feel that you might need a change of eyeglasses. As the crystalline lens loses its transparency and its optical clarity, you may notice that it is not as easy to see well and comfortably in dim illumination, such as for night driving. You may notice that colors look faded. The cloudiness may also create glare, haloes, light sensitivity and a continuing decrease in your vision. If the crystalline lens becomes too cloudy it may cause a significant decrease in both your day and night vision. These are the visual symptoms that are common for those patients whose crystalline lens has clouded and formed a cataract.
Cataracts, Driving & Night Vision
Even if you have good “normal” vision, for many people-especially seniors, night driving poses a greater challenge than driving in daylight. This concern is even greater for people with a cataract as cataracts can make night driving quite stressful-and possibly unsafe. Night vision problems are not unusual even for people who do not have cataracts. Research has demonstrated that in dim lighting, and especially at night, we lose the ability to accurately maintain our focus. This may be due to the fact that under dim or dark lighting conditions, the pupil of our eyes dilates and becomes larger causing a decrease in our “depth of focus”. This phenomenon occurs regardless of age but may be more significant as we get older, and especially for those who have cataracts, as they often experience night driving problems. In addition, cataracts can cause a hazing of vision as well as a scattering of light that can create glare sensitivity and even halos around lights. These types of visual disturbances may be even more noticeable for night driving. This is troubling as the ability to see well in low contrast situations, such as night driving, is critical in seeing lane markers, curbs, barriers and objects in the road. Cataracts reduce your ability to see in low contrast. Therefore, driving with cataracts can be difficult and why night driving problems with cataracts are especially troubling for some patients.
Cataracts, Vision & Presbyopia
In order for you to have clear vision, light must be able to pass through the optical structures of your eyes and focus properly on the retina.
The two primary structures that are responsible for refracting or bending light so that it can focus properly on the back of the eye, are the cornea, which is the outermost clear curved “lens” that is visible when looking at your eye from the side, and the crystalline lens, which is located behind the colored part of the eye, or the iris, and is not directly visible. The crystalline lens will be examined during your eye exam by using specialized instruments to look through the pupil, or the dark center of the iris. Both the cornea and the crystalline lens need to be perfectly clear in order for you to have good vision. If you are in good health and have not had chronic eye infections, inflammation or had any trauma to your eyes, the cornea is likely to maintain its clarity throughout your life. The crystalline lens however, undergoes a number of changes that progress as we age. These aging changes can affect your vision.
Even if you have had “good eyes” and “normal vision” all your life, your vision is likely to begin to change in a number of ways as we progress from our 40’s, to our 50’s and then our 60’s and through our senior years. The most obvious changes to our vision occur as a result of these changes in the crystalline lens.
The two most common changes that occur in the crystalline lens are:
- A loss of optical clarity, which can be caused by a cataract and
- A loss of flexibility, called presbyopia, which makes it harder to read.
Presbyopia & Near Vision
Presbyopia is an aging phenomenon that begins at around age 40 and progresses until about age 65 as the crystalline lens loses its flexibility. This flexibility allows the crystalline lens to change its shape and alter its curvature in order to rapidly focus your vision at various distances, from far to near, to arm’s length, to far or near again. The focusing capacity of the crystalline lens gives you the ability to see things at all distances. Around the time we enter our 40’s, the crystalline lens begins to stiffen. The stiffening of the crystalline lens makes it progressively more difficult to change focus from distance to near, thus making it more difficult to see close up. Initially, this reduces our ability to see objects clearly at arm’s length. As presbyopia progresses, it becomes more difficult to see reading material or objects close up.
As patients begin to experience presbyopia, they often notice that their “arms are too short” requiring them to see up close by moving near objects and reading material farther away in order to bring them into focus and to see them clearly. It is important to know that presbyopia affects everyone, including those who have cataracts. As Presbyopia begins, people who have never worn eyeglasses find that they need reading glasses or bifocals in order to read and see up close. People who already wear glasses may need bifocals or trifocals in order to see up close and have comfortable near vision.