Understanding Cataract Symptoms: When to See an Eye Doctor

Cataracts are the leading cause of vision loss in people over age 40 and the principal cause of blindness worldwide. Yet many people don't realize they have cataracts until their vision has significantly deteriorated. Understanding the early warning signs can help you seek timely treatment and maintain your quality of life.

As a cataract surgeon serving the NYC and Flushing communities, I see patients every day who wish they had recognized the symptoms sooner. The good news is that cataract surgery is one of the safest, most successful procedures in medicine, with excellent outcomes. The key is knowing when it's time to take action.

What Exactly Are Cataracts?

A cataract is a clouding of the eye's natural lens, which sits behind the iris and pupil. This lens is normally crystal clear, allowing light to pass through and focus on the retina. As we age, proteins in the lens can clump together, causing the lens to become cloudy and opaque—much like looking through a frosted or fogged-up window.

Cataracts typically develop slowly over years, which is why the symptoms can be subtle at first. Most people don't notice the gradual changes until the cataract has significantly progressed. This slow progression is actually one reason why cataracts are often underdiagnosed—people adapt to their declining vision without realizing how much they've lost.

Common Cataract Symptoms

1. Blurred or Cloudy Vision

The hallmark symptom of cataracts is increasingly blurred vision that doesn't improve with new glasses. You might feel like you're looking through a dirty or smudged lens. Colors may seem faded or yellowed. This cloudiness gradually worsens over time as the cataract progresses.

Many patients describe it as looking through wax paper or a steamed-up window. Unlike simple refractive errors that can be corrected with glasses, the blur from cataracts comes from clouding within the eye itself.

2. Difficulty Seeing at Night

Cataracts often cause significant problems with night vision. Driving after dark becomes challenging because of reduced contrast sensitivity and increased glare from oncoming headlights. You might notice that street signs are harder to read or that you're uncomfortable driving at night when you used to have no problems.

This symptom can be particularly dangerous and is often what prompts people to finally seek an eye examination. If you find yourself avoiding night driving, it's time to see an ophthalmologist.

3. Increased Sensitivity to Light and Glare

Bright lights can become uncomfortable or even painful. Sunlight might seem too intense, and indoor lighting that never bothered you before may cause discomfort. You might find yourself squinting more often or reaching for sunglasses even on moderately bright days.

Glare is particularly problematic. Car headlights, lamps, or sunlight can create halos or starbursts around lights, making it difficult to see clearly. This occurs because the cloudy lens scatters light rather than focusing it properly on the retina.

4. Seeing "Halos" Around Lights

Many people with cataracts see bright circles or halos around light sources, especially at night. These halos can make driving hazardous and may interfere with daily activities. The halos are caused by light diffracting through the cloudy areas of the lens.

5. Frequent Changes in Eyeglass Prescription

If you find that your glasses or contact lens prescription seems to change frequently—every year or even more often—cataracts could be the culprit. As the lens becomes cloudier and changes shape, your refractive error shifts, requiring prescription updates that provide only temporary improvement.

Some people actually experience temporary improvement in near vision (second sight) in the early stages of cataract development. This occurs because the changing lens causes a myopic shift. However, this improvement is temporary, and vision will eventually deteriorate.

6. Fading or Yellowing of Colors

Cataracts can cause colors to appear faded, washed out, or tinged with yellow or brown. You might not notice this gradual change until after cataract surgery, when patients are often amazed by how vibrant and true colors appear. Many patients tell me they didn't realize how much color perception they'd lost until it was restored.

7. Double Vision in One Eye

In some cases, cataracts can cause double vision (diplopia) in a single eye. This is different from double vision caused by eye muscle problems, which affects both eyes together. If covering one eye eliminates the double vision, the problem is with that specific eye—possibly due to cataracts.

8. Difficulty Reading or Doing Close Work

Reading might become challenging even with proper lighting and reading glasses. You may need brighter light for reading or other close work. Cataracts can make it difficult to see fine details, affecting activities like sewing, reading small print, or working on the computer.

Risk Factors for Developing Cataracts

While age is the primary risk factor for cataracts, several other factors can increase your likelihood of developing them or accelerate their progression:

• Age: Risk increases significantly after age 60
• Diabetes: Diabetics develop cataracts earlier and faster
• Smoking: Doubles or triples your cataract risk
• Excessive UV exposure: Prolonged sun exposure without protection
• Eye injury or inflammation: Past trauma can trigger cataract formation
• Prolonged corticosteroid use: Especially oral or inhaled steroids
• Family history: Genetic factors play a role
• High blood pressure: Increases risk
• Obesity: Associated with earlier cataract development
• Previous eye surgery: Can increase risk
• Excessive alcohol consumption: May contribute to cataract formation

When Should You See an Eye Doctor?

If you experience any of the symptoms described above, it's time to schedule a comprehensive eye examination. Don't wait until your vision has significantly deteriorated. Early detection allows you to plan for treatment and make informed decisions about your care.

At Envision Eye Group in Flushing, we recommend these examination intervals:

• Ages 40-54: Comprehensive exam every 2-4 years
• Ages 55-64: Comprehensive exam every 1-3 years
• Ages 65 and older: Annual comprehensive exams
• High-risk individuals: More frequent exams as recommended

However, if you notice sudden changes in vision, you should see an ophthalmologist immediately regardless of when your last exam was.

How Cataracts Are Diagnosed

Diagnosing cataracts involves a comprehensive eye examination that includes:

• Visual acuity test: Measures how well you see at various distances
• Dilated eye exam: Allows the doctor to examine the lens and retina in detail
• Slit-lamp examination: Provides magnified view of eye structures
• Retinal examination: Ensures no other eye problems are present
• Glare testing: Assesses your sensitivity to light
• Contrast sensitivity testing: Measures ability to distinguish objects from background

These tests help determine the severity of your cataracts and whether surgery is appropriate. Not all cataracts require immediate surgery—your ophthalmologist will discuss the best timing based on how much the cataracts affect your daily life.

Treatment Options: When Is Surgery Necessary?

In the early stages, cataracts may not require treatment. You might manage symptoms with:

• Stronger eyeglass prescription
• Better lighting for reading and other tasks
• Anti-glare sunglasses
• Magnifying lenses for reading

However, when cataracts begin to interfere with your daily activities—driving, reading, working, or enjoying hobbies—surgery becomes the recommended treatment. Cataract surgery is highly successful, with more than 95% of patients achieving improved vision.

The procedure involves removing the cloudy lens and replacing it with a clear artificial intraocular lens (IOL). Modern techniques like femtosecond laser-assisted cataract surgery offer enhanced precision and faster recovery. Many patients achieve better vision after surgery than they've had in years, often reducing or eliminating their dependence on glasses with premium IOL options.

Can You Prevent Cataracts?

While you can't completely prevent cataracts, you can take steps to slow their development:

• Protect your eyes from UV light: Wear sunglasses that block UVA and UVB rays
• Quit smoking: Or never start—smoking accelerates cataract formation
• Manage diabetes: Keep blood sugar well-controlled
• Eat a healthy diet: Antioxidant-rich foods may help protect eyes
• Limit alcohol: Excessive drinking may increase risk
• Have regular eye exams: Early detection allows for monitoring and timely intervention

Don't Let Cataracts Limit Your Life

Cataracts are a natural part of aging, but they don't have to limit your quality of life. Modern cataract surgery is safe, effective, and can restore clear vision, allowing you to continue enjoying your favorite activities. The key is recognizing the symptoms early and seeking evaluation from an experienced ophthalmologist.

If you're experiencing any of the cataract symptoms described in this article, don't wait. Schedule a comprehensive eye examination to determine if cataracts are affecting your vision and discuss your treatment options. The sooner you address cataracts, the sooner you can return to seeing the world clearly.