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How Cataracts Progress

Posted by Neema Nayeb-Hashemi, M.D. on Nov 26, 2018, 8:08:00 AM

You might notice your vision is getting a little cloudy or blurred, or that it’s more difficult for you to drive at night. If you’re noticing these symptoms, especially if you’re older, there’s a chance you might have cataracts. Let’s talk about what that is, exactly, how it progresses, and what can be done about it. 

What Are Cataracts?

Your interocular lens is like an onion with multiple layers. As you age, not only are more layers added, but the protein that accumulates can cause the lens to become less transparent. Additionally, the progressive compaction of the layers can cause the lens to become less flexible, such that the change in shape needed to occur for focusing at different distances become problematic. The net result of these changes is that light cannot focus sharply on the retina even with the best pair of glasses, and vision become blurry. While age is the most common cause of cataract formation, they can also be caused by diabetes, radiation exposure (including chronic sun exposure), inflammation of the eye, trauma, or certain kinds of oral/ocular medication. 

How Cataracts Progress

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Cataracts usually progress slowly. Generally speaking, your cataracts could progress for a year or more without affecting your vision, but eventually the tissues will break down enough that it will begin to affect the way you see. While it can happen in your 40s or 50s, most people don’t experience the negative results of cataracts until after the age of 60. Initially, you’ll probably need glasses and more light to do things you wouldn’t normally need them for. After that, you might notice these symptoms as the lens thickens: 

  • You’ll have clouded, dim, or blurred vision.
  • Night vision will become more difficult.
  • You’ll notice increased sensitivity to light and glare.
  • You may experience halos appearing around light.
  • Your prescriptions will change more frequently to a stronger prescription.
  • Colors will fade or yellow – for example, everything might have a yellow or brown tint to it. At first, it might be so subtle you don’t notice, but gradually, cataracts can have a big impact on how you see the world.
  • You might experience double vision. 

Typically, mild to moderate cataracts are difficult to appreciate by an observer in an undialated eye. However, as cataracts reach an advanced stage, they may become more visible as cloudy white or brown color behind the pupil. People with certain medical conditions, such as diabetes, people who smoke or drink alcohol, or those who have spent a prolonged time in ultraviolet light are more at-risk for cataracts than the average person. Aging is the biggest factor in cataract formation, typically.

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Cataract Surgery

Fortunately, cataract surgery is routine and typically successful. Most doctors recommend surgery only after the cataracts are affecting your day-to-day life – especially reading or driving, which are important to keeping us safe from harm. If your doctor has determined it’s time for you to undergo surgery, your surgeon will go in and remove your clouded lens and replace it with a clear, artificial lens. This is usually an outpatient procedure. While the overall risk is low, it is important to talk to your doctor about your specific risks as well as have your visual goals so that you can make an informed decision on whether cataract surgery is right for you. 

Do you have questions about cataracts? Leave a comment below. 


Dr. Nayeb-Hashemi is a board-certified ophthalmologist at Kelsey-Seybold’s Spring Medical and Diagnostic Center and The Woodlands Clinic. Cataract surgery is one of his clinical interests, which also include pterygium surgery, corneal transplantation, refractive surgery, infectious and immune diseases of the cornea, and conjunctiva.


Topics: cataracts, how do cataracts progress, what causes cataracts

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