What is cataract?

The lens of the eye is normally clear. Light passes through the lens to the light sensitive tissues at the back of the retina, to form an image. A cataract forms when proteins in the lens become damaged. When a cataract develops, the lens becomes cloudy and prevents light from reaching the retina, resulting in blurred vision. In its early stages, a cataract may cause a lessening of vision but eventually it can cause blindness if left untreated. Cataracts usually develop slowly and at different rates in each eye.

What are the risk factors for cataract?

Most cataracts are due to ageing. By the age of 80 years, it is common for people to develop or form some cataract. Other risk factors include:

  • smoking cigarettes
  • exposure to the sun
  • diabetes
  • injury to the eye
  • a history of severe diarrhoeal infection
  • some drugs
  • family history

What are the symptoms of cataract?

Symptoms of cataract can include:

  • blurred vision
  • sensitivity to light (glare)
  • reduced night vision
  • fading or ‘yellowing’ of colours
  • double vision or multiple images in one eye
  • frequent prescription changes in eyeglasses or contact lenses.

How is a cataract detected?

Cataract is detected through a comprehensive eye exam that can include a visual acuity test, dilated eye exam and tonometry. A visual acuity test is an eye chart test which measures how well a person sees at various distances. A dilated eye exam and tonometry need to be carried out by an eye care professional. In a dilated eye exam drops are placed in the eyes to widen, or dilate the pupils and a special magnifying lens is used to examine lens to check for cataract, and the retina and optic nerve for other eye problems. After the exam, close-up vision may remain blurred for several hours. Tonometry is a procedure using a tonometer to measure the pressure inside the eye. Numbing drops may be applied to the eye for this test.

How is cataract treated?

The early symptoms of cataract may be improved with new eye glasses; however, the usual treatment for cataract is surgery. Cataract surgery involves removing the cloudy tissue from the internal part of the lens, and leaving part of the lens capsule behind to act as a support for an implant called an intraocular lens. In most cases only a local anaesthetic (numbing) is needed and the person can go home the same day. Cataract surgery can quickly restore vision and is considered very cost effective.

What is known about cataract among Aboriginal and Torres Strait Islander people?

The National Eye Health Survey 2016 has found that cataract was the second-leading cause of low vision for Aboriginal and Torres Strait Islander Australians. Cataract was the cause of 20% of bilateral vision impairment in Aboriginal and Torres Strait Islander people and 40% leading cause of blindness. Just over 61% of Aboriginal and Torres Strait Islanders who need cataract surgery have had their cataracts removed. Prevalance of vision impairment in Aboriginal and Torres Strait Islanders Australians was more than double in outer regional areas compared to regional areas. The prevalance of blindness and vision impairment among Aboriginal and Torres Strait Islander Australians is three time that of other Australians. Some of the main issues affecting cataract treatment for Aboriginal and Torres Strait Islander people, especially in remote areas are:

  • longer waiting times
  • lack of available eye care services
  • lack of access to surgical services
  • cost of surgery
  • complexity of the steps involved in treatment.

References and further reading

Foreman, J.,Keel, S., Xie, J., van Wijngaarden, P., Crowston, J., Taylor, H.R., Dirani, M. (2016) The National Eye Health Survey 2016: a summary report of the first national survey to determine the prevalence and major causes of vision impairment and blindness in Australia prepared by the Centre for Eye Research Australia and Vision 2020 Australia Centre for Eye Research and Vision 2020 Australia
Fred Hollows Foundation (2012) Cataract. Sydney: Fred Hollows Foundation
Cataract (2008) Centre for Eye Research Australia
Taylor HR, National Indigenous Eye Health Survey Team (2009) National Indigenous eye health survey: minum barreng (tracking eyes): full report. Melbourne: Indigenous Eye Health Unit, The University of Melbourne
Taylor HR, Boudville A, Anjou M, McNeil R (2013) The roadmap to close the gap for vision: January 2013 summary report. Melbourne: Indigenous Eye Health Unit, the University of Melbourne
Anjou MD, Boudville AI, Taylor HR (2013) Nationally consistent spectacle supply for Indigenous Australians.Australian and New Zealand Journal of Public Health; 37(1): 94-95
Boudville AI, Anjou MD, Taylor HR (2013) Indigenous access to cataract surgery: an assessment of the barriers and solutions within the Australian health system. Clinical & Experimental Ophthalmology; 41(2): 148–154

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