By Colleen M. Story

I was chatting with my optometrist after completing my yearly checkup. My vision hadn’t changed, which meant I didn’t have to get new glasses, but he noticed something else.

“You’ve got cataracts,” he told me, “in both eyes.” 

What? 

“They’re cortical cataracts.” 

I later learned that these cataracts develop around the edges of the lens in the eye, and then make their way toward the center in spoke-like shapes. I had those, as opposed to nuclear cataracts—the more common type—which develop in the center of the lens.

Fascinating, if you’re interested in that sort of thing (which I am). But I was still stuck on the fact that I had only recently passed my 50th birthday and yet I had cataracts! 

How the heck did that happen? Don’t you have to be old…er to get those?

According to Johns Hopkins Medicine, age-related cataracts begin to develop between 40 and 50 years old. The National Eye Institute (NEI) agrees, stating that around age 40, the proteins in the lens of your eye start to break down and clump together, forming a cloudy area on the lens known as a cataract. 

It is indeed less common for people to be diagnosed with cataracts at a relatively young age. Research indicates that the incidence of cataracts among individuals aged 43 to 54 is around 8.3%, while for those over 75, the incidence can be as high as 70.5%.

Cataracts can be caused by various factors, and usually, it’s a combination of several. Aging is the primary risk factor—and since we’re all doing that, we’re all at risk. Having a family history of cataracts increases risk, as does prolonged exposure to sunlight, particularly in regions like Western Colorado where sunlight intensity is high.

Other contributing factors include smoking, drinking too much alcohol and certain health conditions such as diabetes. Even in generally healthy people, there may be ongoing changes in the eyes that will eventually lead to cataracts. 

Given these factors, I guess my “early” cataracts may not be considered abnormal. But I wondered—do I have to have surgery right away? 

HOW FAST DO CATARACTS GROW?

Surgery is the only way to fix a cataract. When it’s required depends on how much that cataract has grown, and how fast it will grow in the future. 

There are three main types of cataracts: 

1. Nuclear cataracts: These affect the center of the lens, gradually growing in size and turning the lens a yellow or brown color.

2. Cortical cataracts: These begin as spots or streaks on the outer edge of the lens, then spread to the center. 

3. Posterior subcapsular cataracts: These start as a small spot in the back of the cortex, beneath the lens, right in the path of light. They are most common in people with diabetes or who take steroids, and are the least prevalent of the three.

Subcapsular cataracts grow the fastest. Their growth rate varies from person to person, though. And the speed of their development can fluctuate over time, potentially accelerating or decelerating as you age.

WHEN WILL I NEED
SURGERY?

Now when I go for my next checkup, my primary question for my doctor will be: Do I need surgery yet?

Cataract surgery is one of the most common outpatient procedures in medicine. It typically lasts less than half an hour, though patients may need additional time to recover from the sedative.

It’s also one of the safest surgical procedures. During the procedure, the eye surgeon removes the cloudy lens and replaces it with an artificial one. Modern advancements give patients a choice in lens options. Some block ultraviolet light, while others offer built-in vision correction. Together with your eye doctor, you can determine what type of lens is best for you.

Of course, while all surgeries carry inherent risks, complications are uncommon, particularly if your eyes are healthy going into the procedure. In a 2019 study, researchers found a patient satisfaction rate of 91.42 percent, with additional research suggesting that up to 95 percent of patients experience improved visual acuity post-surgery. 

Still, it makes me a little nervous, so I’m hoping to delay surgery for a while. My doctor recommends waiting until I notice changes in my vision that can no longer be corrected with glasses and contacts. If driving, reading or writing become difficult, for example, then I’ll know it’s time. 

CAN I DO SOMETHING ABOUT THIS?

I’m all about adopting healthy habits to avoid problems, so I checked into how to prevent and slow the progression of cataracts. Unfortunately, based on current research, there’s no way to do that.

All we can do is care for our eyes as best we can. That includes eating a healthy diet, exercising regularly, wearing sunglasses with broad-spectrum UV protection and getting regular checkups with our eye doctor. 

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