If you’ve noticed that your vision is worsening as you age, you might be wondering if what you’re experiencing are the early signs of cataracts, a condition in which the lenses of one or both eyes become clouded and difficult to see through. The symptoms of cataracts can be easily confused with other age-related vision changes, and will progress over time, so at the first sign you should see an eye doctor for a thorough eye examination. (Note that a thorough eye examination is not a simple visual-acuity test and must be performed by a doctor). By proactively getting a diagnosis from a qualified professional, you can get started addressing your vision problems early to help preserve your quality of life as well as your safety and independence.
Even though cataracts are known to progress in severity over time, cataract symptoms are not particularly uniform. They may vary greatly from patient to patient, and there is no firm pattern whereby symptom X appears first and then worsens to symptom Y, and so on.
Cataracts often develop slowly, too, so it can be hard to notice subtle changes that occur over a prolonged time period. And a person may have a small cataract in one eye and not even notice any vision changes because our brains are so good at interpreting imperfect or incomplete visual signals. “Nature gave us two eyes for a reason,” says Jeff Anshel, OD, founder of the Ocular Wellness and Nutrition Society, “because if one goes down, the other takes over. I can’t tell you how many times I’ve covered somebody’s eye and they go, ‘Oh, my God, I can’t see out of that eye!’ The brain will suppress the poorer image and the person goes back to seeing okay.”
Blurred vision. This is probably the most common way people describe living with cataracts. When light hits a lens that has become compressed and clouded over, its rays, instead of passing clearly through, become dispersed and distorted, resulting in an image that is hazy, foggy, or even slightly doubled when it is “read” by the retina. Typically, a cataract only starts out affecting a small part of the lens and gradually spreads to distort more and more of the image. What might begin as a blurring at the center of the image eventually becomes a generalized blurriness.
Light-specific changes. For some people, the earliest sign of a cataract is that they’re not comfortable seeing in the same range of lighting intensities that they used to be. For example, a person may realize that they’ve started switching on their reading lamp at all times of day. Another may start struggling to see objects through the windshield while driving at night. One may begin to see rings or halos around lights shining in the dark, like the moon and stars or approaching headlights. And at the opposite end of the spectrum, a person may find that they can no longer tolerate bright sunlight or harsh interior lighting.
Second sight. A strange thing sometimes happens to people who have begun to develop a nuclear cataract. This type of cataract consists of a hardening and yellowing of the center of the lens which gradually spreads to other areas of the lens. When the person has a history of age-related farsightedness (known medically as presbyopia), sometimes the changes to the lenses that occur in the cataract’s earliest stages cause an improvement in the person’s ability to focus on close-up objects. Alas, this “second sight” is only temporary, but it may be taken as a sign that the eye is developing a nuclear cataract. If you’ve used reading glasses for years and have been gradually increasing the magnification as your vision has worsened, and suddenly you find that you don’t need the readers anymore, it’s doubtful that a miracle has occurred. Instead, it’s a sign that you should get to the eye doctor to see if you have cataracts forming.
Color changes. Another possible early symptom of cataracts is a change in how colors are perceived. Many people report that, with a cataract, colors that were once vivid and vibrant appear pale or washed-out. Frequently, images take on a yellowish hue, as when a yellow filter is applied to the lens of a camera. In fact, that’s scarcely metaphorical, since the person’s formerly clear ocular lens has indeed yellowed. Changes to color may be harder to notice right away than some other vision changes, since they usually don’t interfere with our ability to read, drive, or perform most other daily functions.
If you’ve been experiencing age-related changes to your vision that go beyond presbyopia, you might be wondering whether you have glaucoma or cataracts. In most cases, you’d be unlikely to mix up the symptoms of these two conditions.
Glaucoma occurs when excessive pressure inside the eye causes damage to the optic nerve. There are two main types of glaucoma, neither of which carries symptoms closely resembling those of cataracts described above. Primary open-angle glaucoma causes no pain and does not produce symptoms until an advanced stage. Those symptoms are tunnel vision or blind patches in the vision in one or both eyes. Those blind spots may be at the center or on the periphery of vision. The other type of glaucoma, called angle-closure glaucoma, sometimes does produce blurred vision and halos around lights, which cataracts can also do; but typically, these symptoms would be accompanied by eye pain and redness, severe headache, and nausea.
Don’t try to sort out these symptoms and diagnose yourself. Any time your vision changes noticeably or you experience any of the symptoms associated with either glaucoma or cataracts, see an eye doctor as soon as possible. Both glaucoma and cataracts are treatable, but the sooner you get them taken care of, the better.
