Cataract 18

Cataract 18 is a cloudy or opaque area in the natural lens of the eye, the clear structure that normally focuses light onto the retina to create a sharp image. When the lens becomes cloudy, light cannot pass through clearly, and vision becomes blurred, hazy, or dim.National Eye Institute+1

Doctors may also call this condition “lens opacity,” “clouding of the lens,” “age-related cataract,” “congenital cataract” (when present at birth), or simply “cataract.” All of these terms describe the same basic problem: loss of clarity of the lens leading to problems with vision.Wikipedia+1

Cataracts usually develop slowly and painlessly. They can affect one eye or both eyes, and they are the most common cause of reversible blindness worldwide. If not treated when vision becomes very poor, cataracts can lead to severe visual disability and loss of independence, especially in older people.EyeWiki+1

Types of cataract

There are many ways to classify cataracts. Doctors often name the type based on the location of the cloudiness inside the lens or on the cause. Knowing the type helps to predict symptoms, speed of progression, and the best time for surgery.NCBI+1

Nuclear sclerotic cataract happens in the central part (nucleus) of the lens. The nucleus becomes yellow or brown and hard. People often notice slowly worsening distance vision and sometimes temporary improvement in near vision (“second sight”) before vision later becomes poor for both near and far tasks.Wikipedia+1

Cortical cataract affects the outer layer (cortex) of the lens. White, spoke-like lines or wedges form from the outside toward the center. These can cause problems with glare and halos around lights, especially at night, even when visual acuity on the chart still looks fairly good.NCBI+1

Posterior subcapsular cataract develops at the back of the lens, just in front of the capsule that holds the lens. It often causes glare, difficulty with bright light, and trouble reading, and it may progress more quickly than other types. It is more common in people using steroids or with diabetes.Mayo Clinic+1

Age-related cataract is the most common form. It usually includes a mix of nuclear, cortical, and sometimes posterior subcapsular changes. It results from normal ageing of lens proteins and long-term exposure to light and oxidative stress, and is the main cause of cataracts in older adults.National Eye Institute+1

Congenital or infantile cataract is present at birth or appears in early childhood. It can be caused by genetic changes, infections during pregnancy, or metabolic diseases. If not detected and treated early, it can permanently affect the development of normal vision in the child.National Eye Institute+1

Traumatic cataract follows an injury to the eye. Blunt or penetrating trauma can disrupt the lens fibers and make them cloudy within days, months, or even years. The cataract may be irregular in shape and may be associated with other damage such as iris or retinal injury.NCBI+1

Secondary cataract is a cataract that develops because of another condition or treatment, such as diabetes, long-term steroid use, uveitis (inflammation inside the eye), or previous eye surgery. The underlying disease makes the lens more likely to become cloudy earlier than normal.Mayo Clinic+1

Radiation or toxic cataract can occur after exposure to ionizing radiation, intense infrared heat (for example in glassblowers), or some medications. These forms are less common but important to recognise because they may be preventable with proper protection.EMRO+1

Causes of cataract

Cataracts usually have more than one cause. Often, normal ageing of the lens combines with environmental and health factors to make the lens proteins break down, clump, and become cloudy.Mayo Clinic+1

1. Normal ageing of the lens – Over many years, the proteins in the lens change shape and clump together. The lens also loses its ability to repair damage from light and oxygen. This natural ageing process is the main cause of most cataracts in older adults.National Eye Institute+1

2. Family history and genetic factors – Some people inherit genes that make the lens more likely to turn cloudy early in life. If close family members had cataracts at a young age, the risk of earlier or more severe cataracts is higher.Wikipedia+1

3. Problems during pregnancy and congenital infections – Infections such as rubella, cytomegalovirus, or toxoplasmosis during pregnancy can affect the developing baby’s lens and cause congenital cataracts, sometimes in both eyes.National Eye Institute+1

4. Eye trauma or injury – A strong hit, penetrating object, or chemical burn can damage the capsule and inner fibers of the lens. Cloudiness may appear soon after the injury or gradually over months or years.NCBI+1

5. Previous eye surgery – Surgery inside the eye, such as vitrectomy for retinal problems, can change the environment around the lens and speed up cataract formation. Patients often need cataract surgery some time after such procedures.NCBI+1

6. Long-term use of corticosteroid medicines – Taking steroid tablets, inhalers, injections, or eye drops for months or years can increase the chance of posterior subcapsular cataracts, even in younger adults.Mayo Clinic+1

7. Diabetes mellitus and high blood sugar – When blood sugar is poorly controlled, extra sugar and related products build up in the lens, drawing in water and altering lens proteins. This can lead to earlier and more dense cataracts.Mayo Clinic+1

8. Other metabolic disorders (for example galactosemia) – Rare conditions that affect sugar or mineral handling in the body can change the composition of the lens. In infants and children, these may cause rapid-onset cataracts that require urgent evaluation.EyeWiki+1

9. Excess ultraviolet (UV) light exposure – Long-term exposure to sunlight without eye protection increases oxidative stress in the lens. People who work outdoors in bright sun without sunglasses have a higher risk of cataracts later in life.Mayo Clinic+1

10. Infrared and heat exposure – Jobs that expose the eyes to high heat and infrared radiation, such as glassblowing or foundry work, can damage lens proteins and lead to so-called “glassblower’s cataract.”NCBI+1

11. Ionizing radiation – Medical radiation, radiation therapy around the head and neck, or accidental exposure can damage lens cells. Radiation-induced cataracts may occur years after the original exposure.EMRO+1

12. Smoking tobacco – Smoking increases oxidative damage throughout the body, including the lens, and is a recognised risk factor for earlier and more severe cataracts, especially nuclear types.Mayo Clinic+1

13. Heavy alcohol use – Regular high alcohol intake can contribute to nutritional deficiencies and oxidative stress. Studies show that heavy drinking is linked with a higher risk of cataracts.Mayo Clinic+1

14. Long-standing eye inflammation (uveitis) – Chronic inflammation inside the eye releases inflammatory chemicals and requires frequent steroid treatment. Both the disease and the treatment can promote cataract formation.NCBI+1

15. Chronic eye diseases such as glaucoma and high myopia – Conditions that change eye pressure or eye shape can alter the nutrition of the lens and make cataracts more likely or more complex.NCBI+1

16. Atopic dermatitis and allergic eye disease – Severe atopic disease can be associated with early cataracts, possibly due to chronic inflammation, rubbing of the eyes, and frequent steroid use.NCBI+1

17. Poor nutrition and low antioxidant intake – Diets low in fruits, vegetables, and antioxidant vitamins may leave the lens less protected from light-induced oxidative damage, increasing the risk of cataracts over time.Mayo Clinic+1

18. Certain non-steroid medicines – Long-term use of drugs such as chlorpromazine (an antipsychotic) or miotic eye drops has been linked with cataract formation in some patients.NCBI+1

19. Eye infections after birth – Severe or repeated infections of the eye can damage lens structures or trigger inflammation that accelerates clouding of the lens. This is particularly important in infants and small children.NCBI+1

20. Unknown or mixed causes – In many people, cataracts arise from a mix of age, genetics, lifestyle, and medical factors. Sometimes, no single clear cause is found, but the lens gradually loses clarity over time.Wikipedia+1

Symptoms of cataract

Cataracts usually develop slowly and do not cause pain. Most symptoms are related to reduced clarity of vision and problems with light and contrast.National Eye Institute+1

1. Painless blurred or cloudy vision – Vision becomes foggy or misty, as if looking through a dirty window. People may say their vision is “not sharp” even with glasses, and the blurring often worsens gradually.National Eye Institute+1

2. Trouble seeing at night – Many people notice that night driving becomes difficult. Headlights, road signs, and objects in dim light are harder to see, even if daytime vision is still fairly good.Mayo Clinic+1

3. Sensitivity to bright light and glare – Sunlight, oncoming headlights, or bright indoor lights may feel uncomfortable or dazzling. This glare is especially common in cortical and posterior subcapsular cataracts.National Eye Institute+1

4. Halos around lights – People often describe rings or halos around lamps or headlights. These visual effects come from light scattering as it passes through the cloudy lens.Wikipedia+1

5. Faded or yellowed colours – Colours may look washed out or yellowish. Blues and purples can be especially hard to distinguish, and people may not notice this until after surgery restores normal colour perception.National Eye Institute+1

6. Needing brighter light for reading or close work – Over time, normal room lighting is not enough. People need stronger lamps to read books, sew, or work on close tasks because less light reaches the retina.National Eye Institute+1

7. Frequent changes in glasses or contact lens prescription – The refraction of the eye changes as the lens hardens and becomes cloudy. People may need new prescriptions often, but still feel that vision is not fully corrected.Mayo Clinic+1

8. Double vision in one eye (monocular diplopia) – Some cataracts cause light to split in abnormal ways, creating double or multiple images when looking with just one eye. This is different from double vision caused by eye muscle problems.Wikipedia+1

9. Poor contrast sensitivity – Even when letters on a chart are visible, it can be hard to tell similar shades apart. Faces, steps, or curbs in low contrast settings become harder to see clearly.NCBI+1

10. Difficulty recognising faces or reading signs – Everyday tasks such as recognising people across the room, reading shop signs, or seeing bus numbers become more challenging, especially in dim or bright-light situations.National Eye Institute+1

11. Problems driving, especially at night or in strong sunlight – Cataracts can make it unsafe to drive due to glare, halos, and poor contrast. Many people first seek help when their driving confidence drops.Mayo Clinic+1

12. Temporary better near vision (“second sight”) – In some nuclear cataracts, the lens becomes more powerful and near vision improves for a time, letting an older person read without glasses. Later, however, both near and distance vision decline.Wikipedia+1

13. Reduced depth perception and more clumsiness or falls – When vision is blurred, judging steps, curbs, or distances becomes difficult. This can increase the risk of tripping and falling, especially in older adults.Wikipedia+1

14. Eye strain and headaches from trying to focus – People may squeeze their eyes, move closer to objects, or constantly adjust lighting, leading to eye strain and mild headaches, particularly after reading or screen use.Mayo Clinic+1

15. In children, white pupillary reflex or misaligned eyes – A child with cataract may show a white or gray reflex in the pupil (leukocoria), poor visual attention, or a turned eye (strabismus). These signs need urgent eye specialist review.National Eye Institute+1

Diagnostic test

Physical examination tests for cataract

Physical examination and basic office tests are the first steps in diagnosing cataracts. They help the eye-care professional understand how much the cataract affects daily vision.Health+1

1. Detailed history and general physical exam – The doctor asks about visual problems, general health, medications, and family history, then examines the eyes and surrounding structures. This helps identify risk factors such as diabetes, steroid use, or past eye injuries.Mayo Clinic+1

2. Visual acuity test for distance – Using a Snellen or similar chart, each eye is tested separately with and without glasses. Cataracts typically cause gradual reduction in best-corrected visual acuity, which guides decisions about treatment and surgery.National Eye Institute+1

3. Near vision (reading) test – Small print on a near chart is used to measure how well the person can read at close distance. Cataracts often cause early problems with reading, especially in posterior subcapsular types.National Eye Institute+1

4. External eye inspection with torchlight – A simple penlight or torch is used to look at the cornea, iris, pupil, and lens area. In moderate or dense cataracts, the lens may look gray or white when light is shone into the pupil.NCBI+1

Manual and simple clinic tests for cataract

These tests can be done quickly in the clinic and help to understand how much the cataract is disturbing vision, especially with glare and contrast.Health+1

5. Pinhole test – The patient looks through a small pinhole in an occluder card while reading the chart. If vision improves a lot, the problem may be mainly refractive; if vision stays poor, cataract or retinal disease is more likely.NCBI+1

6. Glare testing – A bright light source is shone toward the eye while the person reads the chart. Cataracts, especially cortical and posterior subcapsular types, often reduce visual acuity much more under glare conditions than in normal room light.NCBI+1

7. Contrast sensitivity test – Special charts with letters of gradually fading contrast (for example Pelli-Robson) are used. Cataracts can significantly reduce the ability to see low-contrast targets, even when standard acuity seems acceptable.NCBI+1

Laboratory and pathological tests related to cataract

Laboratory tests do not diagnose cataracts directly, but they help detect systemic diseases and prepare for surgery, especially in older adults or children with unusual cataracts.NCBI+1

8. Fasting blood sugar and HbA1c – Measuring blood sugar control is essential in people with diabetes or suspected diabetes. Good control reduces the risk of rapid cataract progression and helps reduce complications around the time of surgery.Mayo Clinic+1

9. Kidney and liver function tests – These tests check how well organs handle medications and anesthesia. Poor organ function may require adjustment of drugs used during cataract surgery and recovery.NCBI+1

10. Complete blood count and inflammatory markers – A blood count can show anemia, infection, or inflammation that might affect healing. Markers such as ESR or CRP may be ordered if there is suspected systemic inflammatory disease linked with uveitis.NCBI+1

11. Genetic or metabolic tests in young patients – When a child has cataracts without a clear cause, doctors may request metabolic screening (for example for galactosemia) or genetic testing. Finding the cause can guide treatment and family counselling.National Eye Institute+1

Electrodiagnostic tests in cataract assessment

Electrodiagnostic tests measure how the retina and visual pathways function. They are not needed for every cataract patient, but can be very important when the lens is opaque and the doctor needs to know how well the retina works before surgery.NCBI+1

12. Electroretinogram (ERG) – This test records electrical signals from the retina in response to flashes of light. If the ERG is severely reduced, it suggests retinal disease, which means that vision may not fully recover even after cataract removal.NCBI+1

13. Visual evoked potentials (VEP) – Electrodes on the scalp record the brain’s response to visual stimuli. VEP helps assess the function of the optic nerve and visual pathways. It is useful when cataracts coexist with possible optic nerve disease.NCBI+1

Imaging and instrument-based tests for cataract

Modern imaging and instrument-based exams are central to confirming the presence of cataract, checking the rest of the eye, and planning safe surgery.NCBI+1

14. Slit-lamp biomicroscopy – A slit lamp is a special microscope with a bright, thin beam of light. The eye doctor uses it to examine the cornea, lens, and other front structures in detail and to grade the type and density of the cataract.American Academy of Ophthalmology+1

15. Dilated fundus examination (ophthalmoscopy) – After dilating the pupil with drops, the doctor uses lenses and a light to look at the retina and optic nerve. This exam checks for other diseases, such as macular degeneration or diabetic retinopathy, that can affect visual outcomes.National Eye Institute+1

16. Keratometry and corneal topography – These tests measure the curvature of the cornea. Accurate corneal measurements are needed to calculate the power of the intraocular lens (IOL) that will replace the cloudy natural lens during surgery.NCBI+1

17. Optical biometry or A-scan ultrasound – These tests measure the length of the eye and sometimes other parameters. Together with keratometry, they are used in formulae to choose the correct IOL strength, which is critical for good vision after surgery.NCBI+1

18. B-scan ocular ultrasound – When the cataract is very dense and the doctor cannot see the retina, an ultrasound probe is used over the closed eyelid or anesthetized eye to create images of the back of the eye and rule out problems such as retinal detachment or tumors.NCBI+1

19. Optical coherence tomography (OCT) of the macula – OCT uses light waves to make detailed cross-section images of the central retina. It can detect subtle macular diseases that might limit vision after cataract surgery, guiding counselling and treatment planning.NCBI+1

20. Tonometry for intraocular pressure – Although mainly used to screen for glaucoma, measuring eye pressure is important in cataract patients because glaucoma and cataracts often coexist, and high pressure may change the surgical plan or timing.NCBI+1

Non-pharmacological treatments for cataract

1. UV-blocking sunglasses and hats
   Wearing sunglasses that block 99–100% of UVA and UVB light and a wide-brimmed hat reduces the amount of ultraviolet light reaching the lens. Over many years, UV light speeds up lens protein damage and cataract formation. Using UV protection whenever you are outdoors may slow cataract progression and protect the retina.Cleveland Clinic+1

2. Stop smoking
   Smoking increases oxidative stress in the eye and is a strong, proven risk factor for cataract. Stopping smoking helps lower this risk over time and also protects your heart and lungs. Even after many years of smoking, quitting can still reduce cataract risk compared with continuing to smoke.JAMA Network+1

3. Control blood sugar in diabetes
   High blood sugar makes the lens swell and changes its proteins, which speeds up cataracts, especially in people with diabetes. Good glucose control with diet, exercise and prescribed medicines can slow lens clouding and delay the need for surgery. Regular eye checks are very important if you have diabetes.NCBI

4. Healthy blood pressure and cholesterol control
   High blood pressure and abnormal cholesterol damage tiny blood vessels, including those in the eye. Managing these with lifestyle changes and medicines prescribed by your doctor helps protect overall eye health and may reduce cataract progression indirectly by improving circulation and reducing inflammation.Cleveland Clinic+1

5. Regular comprehensive eye examinations
   Seeing an eye specialist regularly allows early diagnosis of cataracts, monitoring of their growth and timely planning of surgery when vision affects daily life. Eye exams can also detect other problems like glaucoma and macular degeneration at earlier, more treatable stages.Cleveland Clinic+1

6. Improve lighting at home and work
   Bright, non-glary lighting helps cataract patients see better without medicine. Using task lights for reading, high-contrast print, and anti-glare bulbs or shades can ease eye strain. This is a simple but very effective way to improve safety, reading, and daily activities while waiting for or recovering from surgery.Cleveland Clinic

7. Magnifiers and low-vision aids
   Handheld magnifiers, stand magnifiers, strong reading glasses, and electronic magnifiers enlarge print and objects. These tools do not treat cataracts, but they help people function better, maintain independence, and continue reading and hobbies until surgery is planned.Cleveland Clinic+1

8. Driving and mobility counselling
   Professional driving assessment and advice about when to limit night driving or stop driving protect you and others as cataracts worsen. Mobility training, using public transport, or getting help from family can reduce accidents and falls while vision is impaired.Cleveland Clinic+1

9. Fall-prevention strategies
   Cataracts increase fall risk in older adults. Removing trip hazards, using grab bars, improving bathroom safety, and using proper shoes lowers the chance of fractures and head injury. Cataract surgery itself reduces fall risk, but these measures help before and after surgery.Cleveland Clinic+1

10. Avoid unnecessary long-term steroid use
    Long-term use of steroid tablets, inhalers, or eye drops can speed up cataract development. Never stop your medicines on your own, but talk with your doctor about using the lowest effective steroid dose or possible non-steroid alternatives to protect your eyes.NCBI+1

11. Weight management and exercise
    Regular physical activity and keeping a healthy weight reduce diabetes and metabolic syndrome, which are linked to earlier cataracts. Exercise also improves blood flow and antioxidant defences throughout the body, including the eyes, which may help slow lens damage.NCBI+1

12. Limit alcohol intake
    Heavy, chronic alcohol use is associated with higher risk of several eye conditions, including cataracts in some studies. Staying within low-risk drinking limits or avoiding alcohol supports general and eye health and may reduce oxidative damage to the lens.Cleveland Clinic+1

13. Diet rich in fruits and vegetables
    A diet high in colourful fruits and vegetables provides antioxidants like vitamin C, vitamin E, lutein and zeaxanthin, which support lens health and may be linked with lower cataract risk or slower progression. Dark leafy greens, citrus fruits and berries are especially helpful.Frontiers+1

14. Reduce high-sugar and ultra-processed foods
    Frequent intake of sugary drinks, refined carbohydrates and ultra-processed foods worsens insulin resistance and may increase cataract risk through chronic inflammation and oxidative stress. Choosing whole grains and minimally processed foods can support long-term eye health.Frontiers+1

15. Protective eyewear against trauma
    Eye injuries can cause traumatic cataracts. Wearing protective goggles during sports, DIY work, or in risky workplaces lowers the chance of trauma to the lens. This is a simple, non-drug way to prevent sudden cataract formation.moh.am

16. Blue-light and glare reduction
    While research is ongoing, reducing strong glare and intense blue-light exposure with appropriate filters or tinted lenses may make vision more comfortable in cataract patients and could reduce oxidative stress in the lens over time.Frontiers+1

17. Manage other eye diseases
    Controlling glaucoma, uveitis, and severe dry eye with proper treatment can help maintain overall eye health and may reduce complications when cataract surgery is needed. Good control of these conditions leads to better surgical outcomes and safer recovery.moh.am

18. Patient education and counselling
    Understanding what cataracts are, how they progress, and what surgery involves reduces anxiety and helps people make informed decisions. Education also improves adherence to follow-up visits and drop regimens around surgery, which improves visual outcomes.American Academy of Ophthalmology+1

19. Assistive digital tools
    Smartphones and tablets can enlarge text, increase contrast, and use voice-over functions. Simple apps allow cataract patients to read messages and books more easily, supporting independence and mental health while waiting for treatment.Cleveland Clinic

20. Community and psychological support
    Vision loss from cataract can cause fear, depression, or social isolation. Support groups, counselling, and family help can improve quality of life and encourage people to seek timely surgery rather than silently living with poor sight.Cleveland Clinic+1

Drug treatments for cataract

Note: Drugs do not dissolve cataracts; they mainly reduce pain, inflammation, infection risk and complications around cataract surgery. Always follow your eye specialist’s exact prescription.

1. Ketorolac tromethamine ophthalmic (ACULAR)
   Ketorolac 0.5% eye drops are a non-steroidal anti-inflammatory drug (NSAID) used after cataract surgery to reduce pain and inflammation. Typical dosing is one drop four times daily for about two weeks in the operated eye, starting 24 hours after surgery, but your doctor may adjust this. It works by blocking prostaglandin production. Side effects can include eye stinging, irritation, delayed healing, and, rarely, corneal problems.FDA Access Data

2. Ketorolac ophthalmic (ACUVAIL)
   ACUVAIL is a preservative-free ketorolac 0.45% single-use drop indicated for pain and inflammation after cataract surgery. It is usually used twice daily, starting the day before surgery and continuing for two weeks, depending on your surgeon’s plan. It reduces prostaglandin-mediated inflammation. Possible side effects include burning, eye pain and, rarely, corneal thinning.FDA Access Data

3. Phenylephrine + ketorolac intraocular solution (OMIDRIA)
   Omidria is added to the irrigation fluid used during cataract surgery. Phenylephrine keeps the pupil wide, and ketorolac reduces intra-operative and early post-operative pain. A standard dose is 4 mL diluted in 500 mL of irrigation solution used during surgery. Side effects may include eye irritation, increased eye pressure, or rare allergic reactions.FDA Access Data+1

4. Prednisolone acetate ophthalmic (PRED FORTE / OMNIPRED / similar)
   Prednisolone acetate eye drops are corticosteroids used after cataract surgery to control inflammation in the front of the eye. Typical dosing starts with one drop several times a day and is slowly reduced over weeks. They work by suppressing inflammatory chemicals. Side effects can include increased eye pressure, delayed healing and higher infection risk if used long term.FDA Access Data+1

5. Difluprednate ophthalmic emulsion
   Difluprednate is a strong steroid drop used for post-operative inflammation and pain. It is often dosed as one drop four times daily, then tapered as the eye heals. It reduces swelling, redness and discomfort by blocking multiple inflammatory pathways. Side effects include raised intraocular pressure, cataract progression in other settings and increased infection risk.FDA Access Data+1

6. Loteprednol etabonate ophthalmic
   Loteprednol is a “soft” steroid designed to give anti-inflammatory effects with somewhat lower risk of increased eye pressure. It is used after cataract surgery in similar dosing to other steroids, then tapered. It reduces redness, pain and cell reaction in the anterior chamber. Side effects can still include eye pressure rise and infection risk, especially with prolonged use.FDA Access Data+1

7. Combination prednisolone + antibiotic (e.g., PRED-G)
   PRED-G combines prednisolone acetate with gentamicin to treat inflammation when there is risk of bacterial infection after surgery. Dosing is usually one drop several times daily, adjusted by your doctor. The steroid reduces inflammation, and the antibiotic fights bacteria. Side effects include eye irritation, increased eye pressure and possible antibiotic allergy or resistance.FDA Access Data

8. Fluoroquinolone antibiotic drops (e.g., moxifloxacin, gatifloxacin)
   These broad-spectrum antibiotic drops are used before and after cataract surgery to reduce the chance of serious infection inside the eye (endophthalmitis). They are usually used several times a day around the time of surgery. They work by blocking bacterial DNA replication. Side effects include temporary burning, allergy and possible resistance with long or repeated use.American Academy of Ophthalmology+1

9. Ofloxacin or ciprofloxacin ophthalmic solutions
   Older fluoroquinolone drops like ofloxacin and ciprofloxacin are also used for prophylaxis or treatment of bacterial infections after eye surgery. Doses vary but are typically one drop four times a day. They provide broad antibacterial coverage. Side effects include local irritation, white eye deposits and rare allergic reactions.American Academy of Ophthalmology+1

10. Cyclopentolate eye drops
    Cyclopentolate is a cycloplegic drop used before cataract assessment to widen the pupil and relax accommodation, helping accurate measurement and examination. It is instilled in the clinic, usually one or two drops. It works by blocking muscarinic receptors in the iris muscle. Side effects include blurred near vision, glare, and rarely increased eye pressure or systemic anticholinergic effects.FDA Access Data+1

11. Tropicamide eye drops
    Tropicamide is a short-acting mydriatic used to dilate the pupil for pre-operative examination. The usual dose is one drop, sometimes repeated, shortly before the exam. It relaxes the iris sphincter muscle. Side effects include temporary blurred vision, light sensitivity and rare increases in eye pressure in susceptible people.FDA Access Data+1

12. Phenylephrine eye drops
    Topical phenylephrine 2.5–10% can be used to further enlarge the pupil before surgery or exam. It stimulates the iris dilator muscle via alpha-adrenergic receptors. Effects include pupil dilation and sometimes raised blood pressure or heart rate, especially in high-strength solutions, so it is used with care.FDA Access Data+1

13. Brimonidine or timolol eye drops
    In some patients, pressure spikes after cataract surgery need treatment. Pressure-lowering drops like brimonidine (alpha-2 agonist) or timolol (beta-blocker) may be given. They are usually dosed once or twice daily. They reduce aqueous humour production or increase outflow. Side effects include low blood pressure, slow heart rate or breathing problems for timolol, and allergy or dry mouth for brimonidine.moh.am

14. Acetazolamide tablets
    Acetazolamide is an oral carbonic anhydrase inhibitor used short term to reduce very high eye pressure around surgery, particularly in angle-closure or lens-induced situations. Doses vary but are often taken two to four times daily for a brief period. It reduces fluid production inside the eye. Side effects include tingling of fingers, frequent urination, taste changes and kidney stone risk.moh.am

15. Artificial tears and lubricating gels
    Non-prescription artificial tears are often used after cataract surgery to relieve dryness and irritation. Dosing can be several times a day as needed. They work by stabilizing the tear film and reducing friction on the healing cornea. Side effects are usually mild, such as temporary blur; preservative-free options are preferred in sensitive eyes.American Academy of Ophthalmology+1

16. Hyperosmotic sodium chloride eye drops or ointment
    For patients with corneal swelling after surgery, hypertonic saline drops or ointments draw excess fluid out of the cornea. They are typically used several times daily for a short period. This improves clarity and comfort. Side effects can include stinging and irritation, so they are used under specialist guidance.moh.am

17. Non-steroidal oral pain relievers (e.g., paracetamol, ibuprofen)
    After uncomplicated cataract surgery, many patients manage mild discomfort with oral pain relievers. Dosing follows standard adult pain-relief schedules advised by the surgeon. These medicines act through central and peripheral pain pathways. Side effects depend on the drug and include stomach upset or kidney strain with long-term NSAID use.American Academy of Ophthalmology

18. Antibiotic-steroid combination ointments
    In some cases, an ointment combining an antibiotic and a steroid is applied at night after surgery. It offers longer contact time for infection prevention and inflammation control. A small amount is placed in the lower lid at bedtime. Side effects resemble those of separate components: irritation, steroid-related pressure rise and rare allergy.FDA Access Data+1

19. Mydriatic-cycloplegic combinations
    Combination drops that both dilate the pupil and relax accommodation are sometimes used post-operatively to prevent painful ciliary spasm. Dosing is usually a few times daily for several days. Side effects are similar to individual agents: blurred near vision, glare and possible pressure changes.moh.am+1

20. Systemic control medicines (e.g., diabetes, blood pressure drugs)
    Though not cataract drugs, consistent use of prescribed medicines for diabetes, hypertension and lipids is essential around cataract surgery. They stabilize general health and circulation, lowering surgical risk and possibly slowing further lens damage. Side effects depend on each medicine and should be monitored with your primary doctor.NCBI+1

Dietary molecular supplements for cataract support

Supplements cannot cure cataracts. They may support overall eye health. Always discuss with your doctor before starting any supplement.

1. Lutein
   Lutein is a carotenoid concentrated in the lens and retina. Doses in studies are often around 4–10 mg per day. It helps filter blue light and acts as an antioxidant, possibly lowering cataract risk in people with low dietary intake. Evidence is mixed but suggests benefit in some groups. Side effects are rare and usually limited to mild digestive upset.Frontiers+2MDPI+2

2. Zeaxanthin
   Zeaxanthin often works together with lutein. Supplements typically provide 2–4 mg daily, often combined with lutein. It may help protect lens proteins from oxidative damage. Observational studies link higher intake with lower nuclear cataract rates, though large trials show modest or uncertain effects. It is generally well tolerated.PMC+2ScienceDirect+2

3. Vitamin C
   Vitamin C is a water-soluble antioxidant found in citrus fruits and many vegetables. Supplement doses for eye health are often 250–500 mg per day, but many people get enough from food. Higher dietary intake is associated with lower cataract risk in several studies, possibly by reducing oxidative damage in the lens. High doses may cause stomach upset or kidney stones in susceptible people.Frontiers+1

4. Vitamin E
   Vitamin E is a fat-soluble antioxidant that protects cell membranes. Typical supplemental doses range from 100–400 IU per day, though high doses are not suitable for everyone. Some studies suggest it may help protect against age-related cataracts, but results are mixed. High-dose vitamin E can increase bleeding risk and interact with blood thinners.Spandidos Publications+1

5. Zinc
   Zinc is an essential mineral involved in antioxidant enzymes in the eye. Supplements often contain 10–25 mg per day, especially when combined with other AREDS-type nutrients. Adequate zinc status supports retinal and lens health, though most data focus on macular disease. Too much zinc may cause nausea or copper deficiency.Frontiers+2MDPI+2

6. Beta-carotene / vitamin A (diet-focused)
   Vitamin A supports the cornea and low-light vision. It is safer to obtain it from foods rich in beta-carotene, such as carrots and sweet potatoes, rather than high-dose supplements, especially for smokers. Adequate intake may support eye surface health, but high-dose beta-carotene pills can increase lung cancer risk in smokers.Frontiers+2Health+2

7. Omega-3 fatty acids (EPA/DHA)
   Omega-3 fatty acids from fish oil or algae oils (often 500–1000 mg combined EPA/DHA daily) support retinal and tear-film health. They may indirectly help cataract patients by improving dry eye symptoms around surgery, though evidence for direct cataract prevention is limited. Side effects include fishy aftertaste and, at high doses, bleeding risk.Verywell Health+1

8. Alpha-lipoic acid
   Alpha-lipoic acid is an antioxidant involved in energy metabolism. Some experimental and small human studies suggest it may protect lens proteins from oxidative damage, but evidence is still emerging. Typical supplemental doses range from 300–600 mg daily. Side effects may include nausea or low blood sugar in people with diabetes, so medical supervision is needed.Frontiers+1

9. Selenium and other trace minerals
   Selenium, often 50–100 mcg per day in supplements, is part of antioxidant enzymes. Lower selenium levels have been found in some people with cataracts, but data are not conclusive. Balanced mineral intake including selenium, copper and manganese may support overall antioxidant defence. Too much selenium can be toxic, so avoid very high doses.Frontiers+1

10. N-acetylcarnosine eye drops (experimental)
    N-acetylcarnosine is an antioxidant dipeptide studied in eye drops for age-related cataract. Some experimental work suggests it might slow lens clouding or slightly improve clarity, but large, independent trials are limited, and it is not a standard approved cataract treatment. Doses vary by product, and long-term safety is still being studied.Spandidos Publications+1

Immunity-boosting and regenerative / stem-cell related drugs

Important: There are currently no widely accepted, FDA-approved stem cell drugs that reverse cataracts in humans. The following items support overall eye or immune health or are in research; dosing must always be individualized by specialists.

1. Seasonal influenza vaccination
   Flu vaccination does not treat cataracts, but it strengthens overall immunity in older adults, who often also need cataract surgery. Avoiding severe infections lowers surgical risk and supports better recovery. Dose and schedule follow national immunization guidelines (usually annual injection). Common side effects are sore arm and mild fever.Cleveland Clinic+1

2. Pneumococcal vaccination
   Pneumococcal vaccines protect against serious bacterial infections in older or high-risk adults. Better systemic health lowers the chance of complications around eye surgery. Doses and timing are based on age and risk profile. Local pain, mild fever and, rarely, allergic reactions can occur.Cleveland Clinic+1

3. Vitamin D replacement (as a prescribed drug)
   In people with proven vitamin D deficiency, doctors sometimes use higher-dose vitamin D capsules or injections to correct levels. Adequate vitamin D supports bone and immune health and may indirectly benefit eye health in aging. Doses vary widely and must be set by a clinician. Too much vitamin D can cause high calcium and kidney problems.Verywell Health+1

4. Autologous serum eye drops
   These special drops are made from the patient’s own blood serum and used mainly for severe dry eye or surface disease, not for cataracts themselves. By delivering growth factors and nutrients similar to natural tears, they can improve the ocular surface before and after cataract surgery. Concentration and dosing are individualized. Side effects include contamination risk if handling is poor.moh.am+1

5. Limbal stem cell–based therapies (experimental)
   In severe corneal surface disease, limbal stem cell transplants are sometimes used in specialized centres. They aim to regenerate a healthy corneal surface, improving vision and allowing later cataract surgery with better results. Protocols and dosing (cell numbers, carriers) are experimental and strictly controlled in trials. Risks include graft failure and rejection.moh.am+1

6. Lens-regenerating stem-cell approaches (research only)
   Early research in animals and small human studies has explored ways to activate lens epithelial stem cells to regrow a clear lens after removing cataract material. These techniques are not routine, and there are no approved “stem cell drugs” for this purpose yet. Any dosing or procedure details remain experimental and should only occur within regulated clinical trials.Frontiers+1

Surgeries for cataract

1. Phacoemulsification with intraocular lens (IOL) implantation
   This is the most common modern cataract surgery. The surgeon makes a tiny incision, uses ultrasound energy to break the cloudy lens into pieces (phacoemulsification), removes it and inserts a clear plastic IOL. It is done to restore clear vision when cataracts interfere with daily activities. Recovery is usually quick with eye drops and protective measures.American Academy of Ophthalmology+1

2. Small-incision cataract surgery (manual SICS)
   In some regions, surgeons use a slightly larger, but still small, incision and manually remove the lens nucleus instead of using ultrasound. An IOL is then implanted. This cost-effective technique is done when phaco machines are not available or the cataract is very hard. It improves vision similarly but may need a bit longer healing time.moh.am

3. Extracapsular cataract extraction (ECCE)
   ECCE is an older technique still used for extremely dense or complicated cataracts. A larger incision is made to remove the lens in one piece while leaving the back capsule in place for IOL support. It is done when standard phaco is not safe. Recovery takes longer, and sutures may be required, but it can rescue vision in advanced cases.moh.am

4. Femtosecond laser–assisted cataract surgery (FLACS)
   Here, a femtosecond laser performs some key steps such as corneal incisions, lens fragmentation and capsule opening. The surgeon then completes the procedure and places the IOL. It is done to increase precision, especially for premium IOLs or astigmatism correction, though outcomes are similar to standard phaco in many studies.American Academy of Ophthalmology+1

5. Nd:YAG laser posterior capsulotomy
   Months or years after successful cataract surgery, some patients develop a cloudy “posterior capsule” (secondary cataract). A YAG laser is used in clinic to make a small opening in the cloudy capsule, restoring clear vision. It is done when vision again becomes blurred from capsule haze. The procedure is quick, painless, and usually needs no incision.American Academy of Ophthalmology+1

Prevention of cataract

1. Do not smoke, and seek help to quit if you do.JAMA Network+1

2. Wear UV-blocking sunglasses and a hat in bright sunlight.aoa.org+1

3. Manage diabetes, blood pressure and cholesterol carefully.NCBI+1

4. Eat a diet rich in fruits, vegetables and leafy greens.Frontiers+1

5. Maintain a healthy weight and stay physically active.Frontiers+1

6. Limit heavy alcohol intake.Frontiers+1

7. Avoid unnecessary long-term steroid use; ask about safer options.FDA Access Data+1

8. Protect your eyes from injury with safety glasses when needed.moh.am

9. Have regular eye check-ups, especially after age 40 or with risk factors.Cleveland Clinic+1

10. Support general health with enough sleep, stress control and vaccinations.Verywell Health+1

When to see a doctor

You should see an eye doctor if you notice gradually worsening cloudy or blurred vision, difficulty reading, needing more light for close work, or trouble seeing at night and with glare from headlights. These are classic cataract symptoms and can affect safety and quality of life.Cleveland Clinic

Make an urgent appointment if you suddenly lose vision, see flashes of light, many floaters, or have severe eye pain or redness, as these signs may indicate other serious eye problems that can occur with or without cataracts. Prompt care protects your sight.Cleveland Clinic+1

What to eat and what to avoid

1. Eat dark leafy greens like spinach, kale and collard greens for lutein and zeaxanthin that support lens health.Frontiers+1

2. Eat colourful fruits and vegetables rich in vitamin C, such as oranges, berries and bell peppers.MDPI+1

3. Eat nuts and seeds (almonds, sunflower seeds) for vitamin E and healthy fats that support antioxidant defences.Verywell Health+1

4. Eat fish like salmon, mackerel or sardines one to two times a week for omega-3 fatty acids supporting retinal and tear-film health.Verywell Health+1

5. Eat carrots, sweet potatoes and other orange vegetables to provide beta-carotene and vitamin A for general eye health.Health+1

6. Avoid or limit sugary drinks and refined carbohydrates that worsen insulin resistance and are linked to higher cataract risk in diabetes.NCBI+1

7. Avoid or limit heavily salted, ultra-processed foods that may increase oxidative stress and harm overall cardiovascular and eye health.Frontiers+1

8. Avoid excessive alcohol, which can harm many organs and may contribute to eye disease when intake is high.Cleveland Clinic+1

9. Be careful with high-dose single-nutrient supplements (especially beta-carotene if you smoke); use balanced formulas only under medical advice.Verywell Health+1

10. Stay hydrated with water and limit sugary caffeinated drinks to support tear production and general eye comfort.Verywell Health+1

Frequently asked questions about cataract

1. Can eye drops cure a cataract?
   No. At present, cataracts cannot be dissolved or cured with eye drops, supplements or medicines. The only proven way to remove a cataract is surgery to take out the cloudy lens and replace it with a clear artificial lens. Drops are used only to control inflammation, pain and infection risk around surgery.Cleveland Clinic+1

2. Will cataracts grow back after surgery?
   The removed natural lens does not grow back. However, the thin “bag” (capsule) holding the artificial lens can become cloudy months or years later, causing blurred vision again. A quick YAG laser procedure opens this capsule and restores clarity, so people sometimes call this a “secondary cataract.”American Academy of Ophthalmology+1

3. At what stage should I have cataract surgery?
   There is no fixed number. Surgery is usually recommended when cataracts make it hard to read, drive, work or live safely, and when glasses no longer help enough. Your eye doctor will discuss your symptoms, eye findings and general health to decide the best time together with you.Cleveland Clinic+1

4. Is cataract surgery safe?
   Modern cataract surgery is one of the most common and successful operations worldwide. Serious complications are rare but can include infection, bleeding or retinal detachment. Using prescribed drops, following instructions and attending follow-up visits help keep risk low and outcomes excellent.American Academy of Ophthalmology+1

5. Does everyone with cataracts need surgery?
   Not always. If cataracts are mild and vision is still good, many people manage with stronger glasses, better lighting and low-vision aids. Surgery becomes necessary when symptoms interfere with daily life or safety, or when the lens obstructs examination or treatment of other eye conditions.Cleveland Clinic+1

6. Can lifestyle changes really slow cataracts?
   Lifestyle changes cannot remove existing cataracts, but not smoking, controlling diabetes, protecting from UV light and eating a nutrient-rich diet may reduce risk or slow progression. These steps also protect the rest of your body, so they are strongly recommended.NCBI+2JAMA Network+2

7. Are antioxidant supplements necessary if I eat well?
   If you already eat a diet rich in fruits, vegetables, nuts and fish, you may not need extra supplements. Research shows mixed results; some people with low dietary intake may benefit from added lutein/zeaxanthin and other nutrients, but supplements are not a magic shield and should be personalized.PMC+2ScienceDirect+2

8. Do cataracts affect both eyes at the same time?
   Age-related cataracts often develop in both eyes, but one eye may be worse or reach a surgical stage earlier than the other. Your doctor may treat the more affected eye first and schedule surgery for the second eye later for safety and convenience.Cleveland Clinic+1

9. Will I still need glasses after cataract surgery?
   Many people see much better without thick glasses after surgery, especially for distance. However, you may still need glasses for reading, computer work, or very fine tasks, depending on the type of intraocular lens chosen and any remaining astigmatism or refractive error.American Academy of Ophthalmology+1

10. Is cataract surgery painful?
    Most people feel pressure but not sharp pain because local anaesthetic drops or injections are used. Mild discomfort or scratchiness is common for a few days after surgery and is usually controlled with drops and simple pain relief. Severe pain is unusual and should be reported immediately.American Academy of Ophthalmology+1

11. How long does it take to recover from cataract surgery?
    Many people notice clearer vision within a few days, but full healing can take several weeks. During this time, you will use eye drops, avoid rubbing the eye and follow activity restrictions such as no heavy lifting or swimming until your surgeon says it is safe.American Academy of Ophthalmology+1

12. Are there special risks for people with diabetes?
    People with diabetes may develop cataracts earlier and are at higher risk of macular swelling after surgery. Good blood sugar control before and after surgery, careful retinal monitoring and sometimes extra medicines help reduce these risks and improve outcomes.NCBI+1

13. Can children get cataracts?
    Yes. Cataracts can be present at birth (congenital) or develop in childhood from genetic causes, infections or injuries. These require urgent specialist care because they can seriously affect visual development. Treatment often involves surgery and careful visual rehabilitation.moh.am+1

14. Does cataract surgery increase the risk of other eye diseases?
    Cataract surgery slightly changes the eye’s structure. There is a small increased risk of retinal detachment, macular swelling or capsule clouding, but the benefit in vision usually far outweighs these risks. Regular follow-up helps detect and treat any complications early.American Academy of Ophthalmology+1

15. What is the most important step I can take today?
    If you suspect cataracts or have been told you have them, the most important step is to schedule an eye examination and discuss your symptoms, lifestyle and health conditions. At the same time, stop smoking if you smoke, protect your eyes from UV light and start a healthy, colourful diet to support your long-term vision.Cleveland Clinic+2JAMA Network+2

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: November 14, 2025.