Introduction

Cataracts are ‘slow’ developers. Therefore, you may not even realize that you have them. You notice only when you have difficulty with driving at night, reading, etc. Naturally, you will have to go in for a medical consultation. During the examination, the ophthalmologist may find the cataract affecting the central part of the lens. The center is the nucleus. This indicates that you are suffering from nuclear cataracts.

Symptoms of Nuclear Cataracts

They are common in older adults or the elderly. Therefore, people refer to them as senile cataracts (age-related) too. You may recognize them via the following symptoms.

  • The cataracts take over the nucleus/central region of the eye lens.
  • Over time, the lenses become thick and hard. 
  • They take on a yellowish hue.
  • As the condition progresses, the lenses appear brown in color. 
  • All objects seem to take on a blurred or dull look. 
  • You find it difficult to see anything in bright light.
  • You cannot tolerate the glare of headlights at night.
  • You may even be seeing halos around shining objects at night.
  • Sometimes, you experience double vision.
  • Colors appear faded or dull. 
  • You may not be able to distinguish between colors very well.
  • Driving proves difficult because you cannot judge distances appropriately, read street signs or view people clearly.
  • Your distant vision suffers the most.

Surprisingly, the ability to read improves, indicating the advent of short-term second sight. Alternatively, you may experience nearsightedness.

Then again, nuclear cataracts may co-exist with glaucoma. This disease destroys the optic nerve in the eyes. Therefore, vision is impaired.

Causes of Nuclear Cataracts

It is true that older people are more prone to the appearance of cataracts. However, it need not always be so. Alternative risk factors are, 

  • Underlying health problems
  • A genetic issue at birth
  • Heavy exposure to UV light
  • Excessive usage of steroids
  • Smoking
  • An eye injury 

What actually causes the formation of nuclear cataracts?

  • The lenses of the eyes comprise of a combination of water and protein fibers. 
  • The arrangement of these fibers is such that it permits maximum light to pass through them.
  • During the aging process, there is a growth of new fibers. 
  • They show up at the edges of the lenses.
  • They push the older fibers out of the way, towards the nuclei of the lenses.
  • The proteins begin to clump, thereby scattering the light rays coming towards them.
  • As the central region becomes denser, refusing to let the light come through, you find yourself unable to see anything clearly.

Treatment of Nuclear Cataracts

You may try strong bifocals or glasses, a magnifying lens, visual aids or suitable illumination. Regardless, the best solution for your problem is phacoemulsification cataract surgery.

  • To begin with, the surgeon brings an ultrasonic device into play.
  • The sound aids in breaking up (phaco) the cataract or the cloudy lens (solid-liquid lens and cortex or emulsified material). This is cataract phacoemulsification
  • A small tube, serving as a vacuum cleaner, suffices to pull out the pieces.
  • Finally, the surgeon inserts a new intraocular lens into the blank space.
  • Femto cataract surgery– The phacoemulsification procedure is further advanced by using a femtosecond laser to make the opening in the eye and the lens anterior capsule, fragment the lens material into tiny pieces and place toric cuts on the cornea in case there is high cylindrical power in the eye. This makes the surgical outcome more predictable and safe. 

Sometimes, the patient is a younger adult. The ophthalmologist discovers congenital cataracts during a routine eye examination only. 

  • They are asymptomatic. 
  • They are a rare occurrence.
  • The region surrounding the nucleus appears bluish in some areas.
  • The opacities are akin to blue puncture marks/dots at irregular intervals. 

In general, the prognosis of any cataract surgery is good.

Do meet the cataract specialists for a proper consultation and the right course of the treatment.

Dr. Swapnali Sabhapandit

Dr. Swapnali Sabhapandit

MS, FLVPEI Cornea Specialist at Neoretina
Dr. Swapnali completed her MBBS from Gauhati Medical College, Guwahati, Assam. She did her MS (2004-2007) from the Regional Institute of Ophthalmology, Guwahati, Assam. She did clinical Cornea and Anterior Segment Fellowships from Aravind Eye Hospital, Pondicherry and subsequently from LV Prasad Eye Institute, Hyderabad. Dr. Swapnali is a skilled surgeon and her special interests include LASIK and refractive surgeries, management of keratoconus and corneal transplant surgeries.
Dr. Swapnali Sabhapandit