Source: PHYSICIANS COMMITTEE FOR RESPONSIBLE MEDICINE Cataracts are extremely common. They affect an estimated 15 million people and are responsible for nearly half of all cases of blindness worldwide. A cataract occurs when the lens of the eye becomes cloudy or opaque. This happens gradually, as proteins in the lens become oxidized. Doctors do not know exactly why this occurs, but they believe that a combination of environmental factors (such as toxins and sunlight exposure) and genetic factors are involved.
Cataracts can occur in specific areas or throughout the lens. The process usually occurs very slowly over the course of years or decades, and it usually affects both eyes.
Cataracts are not painful. The most common symptoms are loss of vision, blurred vision, or double vision. In general, long–distance vision is lost before near vision. Some patients say that they see a halo effect around lights. Others note excessive glare during night driving and in bright light, especially sunlight.
Risk Factors
Although the exact cause of cataracts is unknown, there are several factors that increase risk of cataract formation. These include:
- Smoking: Doctors believe that at least 20 percent of cataracts in the U.S. occur due to cigarette smoking.
- Increasing age: Most cataracts occur in individuals over 60.
- Family history of cataracts
- Diabetes mellitus
- High cholesterol
- Obesity
- Excessive alcohol use
- Excessive sunlight exposure
Cataracts: Diagnosis and Treatment
Diagnosis
Cataracts should be suspected in any individual with a slow, painless loss of vision. Using a microscope, an ophthalmologist can directly observe the cloudy areas of the lens.
Treatment
First, since smoking and obesity increase the risk for cataracts, it is important to avoid smoking and maintain a healthy weight.
Surgery is the only definitive treatment. Once cataracts occur and loss of vision becomes significant enough to interfere with the activities of daily life, surgery is usually necessary.
Before surgery, it is important to make sure that blood pressure and blood sugar are under control. If you take medications, discuss with your doctor whether you should continue taking the medications in the days leading up to surgery.
Cataract surgery is a relatively simple, low–risk procedure with a very high success rate. It takes only a few hours and patients do not need to be hospitalized. The surgeon will remove the cloudy lens and replace it with a clear lens.
Afterward, individuals can resume normal activities immediately, including reading and watching television. Most people have significantly improved vision. In some cases, patients will be asked to avoid driving for a few days or until the eye heals sufficiently.
Cataracts: Nutritional Considerations
There are many simple ways to decrease the risk of cataracts by making small changes in your daily life:
- A diet rich in antioxidants: Because the formation of cataracts is associated with oxidation, consuming more antioxidant–rich fruits and vegetables may help prevent cataracts.Vegetables that contain high amounts of carotenoids are especially important. In particular, leafy green vegetables, such as spinach, broccoli, kale, collards, mustard greens, and turnip greens are excellent sources of the antioxidant carotenoid lutein, which is present in the lens of the eye.Vitamins C and E also appear to be important in preventing cataract formation and progression. Good sources of vitamin C include citrus fruits, peppers, tropical fruits, cantaloupe, strawberries, kiwi, cruciferous vegetables, tomatoes, potatoes, and sweet potatoes. Good sources of vitamin E include wheat germ, cooked spinach, soymilk, many varieties of nuts, sunflower seeds, mangos, and olive, peanut, and vegetable oils.It is also prudent to take a daily multivitamin. However, vitamin supplements do not take the place of a healthy diet with plenty of fruits and vegetables.
- Maintenance of a healthy cholesterol level: Studies show that high levels of cholesterol and triglycerides result in increased risk of cataracts. Also, low levels of high density lipoprotein (HDL, or “good”) cholesterol, can increase the risk of cataracts.The best way to lower cholesterol is by avoiding foods that are high in saturated fats, such as meat and dairy products, and trans fats, such as snack pastries and commercial fried foods.
- Reduction in fat intake: Studies show that fatty diets boost cataract risk by about 10 percent. As noted above, the most important fats to avoid are saturated fats and trans fats.
- Avoiding dairy products: Studies suggest that some individuals benefit from avoiding dairy products. The problem, at least theoretically, is that the lactose in dairy products breaks down during digestion to release a smaller sugar, called galactose, which can enter the lens. Especially vulnerable are individuals with a disease called galactokinase deficiency. Dairy products should be avoided in these individuals due to their contributing the majority of galactose to the diet. Further, dairy products are high sources of fat and saturated fat, which is known to raise cholesterol levels.
- Avoiding excessive use of alcohol: People who drink more than two glasses per week of any type of alcohol (beer, wine, or distilled spirits) have a greater than 10 percent risk for some types of cataracts.
- Maintenance of a healthy weight: Studies show that obese individuals have a greater than 30 percent risk of cataracts compared with healthy weight individuals.
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