Consequences of not undergoing cataract surgery

Written by Deng Jiang Tao
Ophthalmology
Updated on September 09, 2024
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First, it is important to understand what cataracts are. Cataracts are the clouding of the lens cortex, which commonly refers to the gradual whitening of the central pupil area, the black part of the eye. Cataracts, based on their stage of development, are divided into early, middle, and late stages. In the early stage of cataract, the vision is slightly impaired. In the middle stage, the cortex becomes moderately clouded, and vision might still be around 0.4 or 0.5. In the late stage, the cataract is severely matured, generally with vision lower than 0.3. Cataract in its early and middle stages might not necessarily require immediate surgery. However, in late stages, when vision drops below 0.3, surgery should be considered. If not treated surgically, the mature cataract can completely block light, progressively decreasing vision and eventually leading to blindness. Therefore, it is advisable to consider surgical treatment for cataracts in the late stage.

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How is a cataract formed?

Inside the eyeball, there is a relatively important transparent tissue called the lens. Clinically, clouding of the lens is referred to as cataracts. Many factors, such as aging, genetics, metabolic abnormalities like diabetes, trauma, radiation, poisoning, and local nutritional disorders, can lead to damage to the capsule of the lens, increasing its permeability and losing its barrier function, or causing metabolic disturbances in the lens. This can cause the proteins in the lens to denature, leading to cloudiness of the lens, which is known as cataracts. Under a slit lamp microscope, varying degrees of cloudiness in the lens can be observed.

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Causes of cataracts

Various causes, such as aging, genetics, local nutritional disorders, immune and metabolic abnormalities, trauma, poisoning, radiation, etc., can lead to metabolic disorders of the lens, causing the denaturation of lens proteins and resulting in cloudiness; this is called cataract. Cataracts can be divided into congenital and acquired. Congenital cataracts, also known as developmental cataracts, are divided into anterior polar cataracts, posterior polar cataracts, nuclear cataracts, and total cataracts. Acquired cataracts are divided into senile cataracts, complicated cataracts, traumatic cataracts, metabolic cataracts, radiation cataracts, and those related to medications and poisoning.

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Does cataract cause headache?

The main symptoms of cataracts include a decline in vision, with both near and far objects appearing unclear, and blurry vision. There is no significant eye pain or headaches, nor does it cause redness in the eyes. If headaches do occur, it is important to investigate the cause, such as checking if there is an increase in eye pressure or if the headache is caused by glaucoma, and to treat according to the specific cause. However, in the later stages or over-mature stage of cataracts, the lens may dissolve, which can potentially lead to phacolytic glaucoma, but this condition is very rare.

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Do cataracts replace the lens?

Cataracts refer to the clouding of the lens, leading to decreased vision. Cataract surgery involves removing the cloudy lens and replacing it with an artificial one to restore vision. Simply removing the cataract lens does not restore vision, as it leaves the eye in a highly hyperopic (farsighted) state. An artificial lens must be inserted to improve vision and correct the eye's refractive state. Therefore, cataract surgery necessitates the replacement of the lens.

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Symptoms of cataracts

The symptoms of cataracts are diverse. Firstly, the most primary manifestation is a decline in vision, which is a painless and gradual decrease. Unlike glaucoma, where the decrease in vision is accompanied by swelling pain in the eyes and even headaches, the vision decrease in cataracts occurs gradually and not suddenly. If the onset is sudden, then it is generally not considered to be caused by cataracts. Besides the painless, gradual decline in vision, some patients may experience a decrease in contrast sensitivity, and changes in refraction. For example, patients who have presbyopia might find that their presbyopia diminishes and their nearsightedness worsens if they develop cataracts, particularly nuclear cataracts. Some people may experience monocular diplopia or polyopia, as well as varying degrees of visual field defects.