Cataract symptoms, treatment and causes

Symptoms and signs of cataracts include vision problems such as:

• Cloudy or blurry vision  
• Sensitivity to bright lights
• More trouble than usual seeing in the dark or low light 
• Colours appearing more faded than normal
• Seeing a halo or glare around lights 
• Double vision
• Needing new prescription lenses more often
• Sometimes, temporary improvement in close-up vision 

Cataract symptoms and signs

Cataracts usually develop gradually, and the symptoms aren't painful. Cataracts are one of many eye conditions that can be detected during a routine eye exam by an optician or ophthalmologist (eye specialist). The NHS recommends having regular eye tests at least once every two years.

The most noticeable early cataract symptom is usually blurred or double vision. Other early signs include vision changes such as cloudiness to your vision, trouble seeing at night, being more sensitive to bright lights, seeing a halo or glare around lights, colours appearing faded, and needing new prescriptions for eyeglasses or contact lenses more often. Some people can experience a temporary improvement in their short-sightedness, but this doesn't last.

If cataracts aren't treated, they can lead to worse symptoms, including:

• Significant blurring of vision
• Loss of colour vision, colours may appear yellow or brown
• Vision loss
• Sometimes, advanced cataracts can be painful

Different cataract symptoms

Symptoms can vary with different types of cataracts:

• Nuclear cataracts can temporarily improve your close-up vision, but it slowly turns the lens of the eye more yellow, clouding the vision.
• Cortical cataracts can cause you difficulty with glare and night vision.
• Posterior subcapsular cataracts can progress faster than other types, affecting how well you see detail (visual acuity), your ability to see in bright light, and causing halos around lights in the dark.

Eye tests for cataracts

It’s important to go for regular eye tests to help detect eye conditions like cataracts, which don’t always have noticeable symptoms at first. The NHS recommends having an eye test at least every two years. You might need to have them more often as you get older, and if you’re at increased risk, for example, with a family history of a particular eye condition like glaucoma.

It may be difficult for parents and carers to spot the symptoms of cataracts in children and babies. Babies' and children's eyes are checked at various points during their development, and you can take your child for an eye examination from any age. Regular eye exams can help detect a range of eye conditions that can develop in children.

Diagnosis of cataracts

During an eye test, your optician will assess your sight at different distances (known as a visual acuity test), as well as examining your eye to check for early signs of cataracts and other eye conditions. 

They may give you special eye drops to help them examine parts of your eye. These are painless.

If they find cataracts, they'll refer you to an ophthalmologist for further assessment and advice about treatment.

Cataract surgery and treatment

Cataracts can lead to vision loss if left untreated, but cataract surgery is usually an effective solution. Like all surgical procedures, there are risks associated with eye surgery, and you should ask your GP or specialist eye doctor any questions you have.

Before having surgery, there are some things you can do to make daily activities easier while living with cataracts.   

How to treat cataracts

Visual aids such as stronger prescription glasses, brighter lights, and magnifying lenses can help you cope with early symptoms. 

Eventually, however, cataract surgery is usually necessary. Surgery is the main treatment available to improve your eyesight. It involves removing the affected lens and replacing it with an artificial lens (also known as an intraocular lens or IOL). 95% of people experience improved vision after surgery if they don't have other eye conditions (Source: Guy's and St Thomas'). 

You’ll discuss when it’s right to have cataract surgery with your doctor. It will depend on factors such as:

• How cataracts affect your sight and the risk of vision loss
• Your lifestyle and daily activities 
• Other conditions affecting your eyes, such as glaucoma, or general health
• The risk of surgery, such as damage to your retina or cornea 
• The benefits of surgery and what you would gain

Some people develop secondary cataracts after surgery (called posterior capsule opacification). This causes clouding in your vision, but laser treatment is available and painless with anaesthetic eye drops.

Cataracts in children will usually need more urgent surgery to prevent other problems from developing with their vision. 

Causes of cataracts

Factors that may increase the risk of cataracts include:

• Age
• Family history of cataracts
• Smoking
• Diabetes
• Excessive alcohol consumption
• Eye injury and eye surgery
• Taking corticosteroids for a long time.
• Exposure to ultraviolet (UV) rays and radiation treatment 
• Having learning disabilities 

In rare cases, cataracts can develop in children, either before birth (congenital cataracts) or later in childhood.

Preventing cataracts

Age is the most common factor in developing cataracts, although they can occur in children and even babies. 

A healthy, active lifestyle can help maintain good eye health and limit a range of eye problems. It's also a good idea to wear sunglasses to protect your eyes from ultraviolet light. 

Frequently asked questions

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.