Cataracts. Can They be Prevented?
By Michael J. Dodd, MD

Many patients who visit my office are diagnosed with cataracts. They will ask what causes cataracts and if they can be prevented. The term cataract is Latin meaning waterfall. This undoubtedly derived from the appearance of an advanced or mature cataract, which is white. So in ancient times if an elderly person lived long enough to develop a white cataract, their pupil would look white instead of the normal black appearance; it appeared that they had a “waterfall” in their pupil. White cataracts are rare in the United States today because they are usually diagnosed and removed before they advance to the mature stage.
What is the cause of a cataract? Everyone has a soft, flexible, clear lens, which is located behind the iris — the colored part which gives us brown or blue eyes. The natural lens functions by changing shape due to tension on the equator of the lens. This change in shape allows us to focus near and far. As we age the lens becomes less flexible and focusing nearby becomes more difficult. This is common in the early 40s and reading glasses solve this problem. As the eye continues to age, the lens becomes more cloudy and it is more difficult for light to pass through the hazy lens. This is the beginning of a cataract. Eventually, the cloudiness becomes significant enough to impair the vision, even with the benefit of glasses. Once the best-corrected vision drops below 20/40, it is time to consider cataract surgery. Aging, then, is obviously the cause of cataracts. It is natural to develop a cataract. If people live long enough, everyone will get them. Even animals get cataracts. So far we have no method to prevent the development of cataracts. There is research to see if any drugs could prevent their growth, but so far there have been no promising results.
The only treatment is surgical removal and replacement with a tiny soft plastic “lens implant.” Today there are a variety of lens implants available to correct vision. Some implants correct for distance vision only, while some correct for both distance and nearby vision. Your eye surgeon will discuss the various options available.

Dr. Dodd is a practicing ophthalmologist at Maryland Eye Associates located in Annapolis, Prince Frederick and Upper Marlboro, as well as an instructor at the University of Maryland Department of Ophthalmology. He can be reached at 410.224.4550 or [email protected]

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