CADILLACS....uh...er...CATARACTS
I've heard them called nearly everything, and described as "growths over the eyes" to "tumors in the pupil". Let's clarify some real misconceptions about cadillacs...uh...er...cataracts. Most importantly, cataracts are NOT growths or tumors and they do not affect the front part of the eye, the cornea. A cataract is simply a cloudiness of the lens tissue that may inhibit the amount of light that can reach the retina. The lens is located just behind the pupil and iris (colored part) and can't be seen under normal circumstances. It is roughly the size of a pea and is quite transparent in our early years. As we age, the lens becomes somewhat cloudy, and takes on an amber color. If the cloudiness progresses it begins to "filter" out the light around us and an insufficient amount reaches the retina for good, clear vision. Look out a dirty or steamy window and you'll get the idea.
By far, the most common form of cataract is the "age-related nuclear sclerotic" type. This is a slow, progressive yellowing of the nucleus of the lens and causes difficulty primarily with your distance vision. A fewer number of people will complain about their reading. Ironically, there will be some patients that actually report an improvement in their reading ability, and many will actually remove their glasses to read better! This so-called "second-sight" is a mixed blessing, for it probably means that the cataract is progressing causing a nearsighted shift in vision.
Some degree of nuclear sclerosis occurs in all of us, but the rate of progression will vary depending on several things. Heredity certainly plays an important role as well as your environment. There is evidence that overexposure to ultraviolet radiation over a long period of time can be a factor. There is also evidence that smoking and diet may play a role. And the good/bad news is that we are living longer and these cataracts simply have more time to develop.
Another common type of cataract is the "posterior subcapsular" form. This type can result from a variety of causes including x-ray exposure, injury or trauma to the head or eye, or a prolonged course of certain systemic medications, in particular, corticosteroids. As the name implies, the PSC (posterior subcapsular cataract) is positioned near the back of the lens, just inside the capsule. (The capsule is a "bag" that holds the lens in place in the eye) This cataract causes a great deal of glare and may affect your reading ability more than your driving vision. Many people with this form will also report seeing better in the dark than on a bright day. Daytime light will cause your pupil to constrict (as with reading) and any light available will have to pass directly through the PSC opacity, causing a significant loss of clarity.
Now that you ALL feel like you have cataracts......please be reassured that the symptoms I have discussed are much more commonly found as a result of simple changes in your vision, temporary medications, fatigue, and too much TV or computer strain. Cataracts are rare under the age of sixty and MOST of them will never need surgery! If you ever do need surgical correction, the techniques employed today will astound you.
The IOL (intra-ocular lens) implant has revolutionized cataract surgery. A procedure that thirty years ago required a week in the hospital and ultra-thick eyeglasses following surgery, is now an out-patient procedure that REPLACES your own lens with a clear one and sends you back to work in a day or so. Recovery times will vary, but you get the idea. And, for a procedure that used to require a dozen stitches, there is now the "no-stitch" operation, truly a remarkable event.