Cataracts in Tanzania: Symptoms, Causes & Treatment | aihealz
OphthalmologymoderateICD-10 · H26.9
Cataracts.Care & specialists in Tanzania
In Tanzania, cataracts is managed by ophthalmologists. A cataract is a clouding of the crystalline lens of the eye that causes painless, progressive loss of vision and is the single leading cause of blindness worldwide. The Global Burden of Disease 2020 estimates 100 million people have moderate-to-severe vision impairment from cataract and 17 million are blind from untreated cataract, with the heaviest burden in South Asia, sub-Saharan Africa, and Latin America where surgical access is limited.
aliases · Cataracts (clouding of the eye lens)· Lens opacification· Catarata· Cataracte· reviewed May 14, 2026
EB
Reviewed by AIHealz Medical Editorial Board · OphthalmologyLast reviewed May 13, 2026
A cataract (ICD-10: H25 age-related, H26 other, H28 cataract in diseases classified elsewhere) is an opacification of the crystalline lens of the eye, the biconvex transparent structure behind the iris that focuses light onto the retina. With age, lens proteins (crystallins) undergo oxidative modification, cross-linking, and aggregation, producing progressive loss of transparency. The clinical classifications of age-related cataract are: nuclear sclerotic (the most common, in which the central nuclear lens darkens and yellows, producing 'second sight' myopia and gradual visual loss); cortical (spoke-like cortical opacities radiating from the equator into the visual axis, often with glare and difficulty in bright sunlight); posterior subcapsular (a plaque-like opacity beneath the posterior lens capsule that disproportionately impairs near vision and produces marked glare, often appearing earlier in life and accelerated by corticosteroid use, diabetes, or radiation); and anterior subcapsular and mixed cataracts (combinations of these features). Beyond age-related cataract, congenital cataract (present at birth, often from genetic mutations, intrauterine infection, or metabolic disease), pediatric cataract (developing in childhood), traumatic cataract (after blunt or penetrating ocular injury), iatrogenic cataract (after intraocular surgery or systemic corticosteroid use), and metabolic cataract (in diabetes, galactosemia, Wilson disease) account for the remaining cases.
key facts
Prevalence
Approximately 100 million people with moderate-to-severe vision impairment from cataract globally; 17 million blind from untreated cataract (GBD 2020)
Demographics
Age-related cataract affects over 50% of US and UK adults over age 80; congenital and pediatric cataract affect approximately 3 per 10,000 children
Avg. age
Most cataract surgery performed at age 65-80; bilateral surgery sequentially over weeks to months
Global cases
Over 28 million cataract surgeries performed globally each year; surgical backlog remains large in low-income countries
Specialist
Ophthalmology
ICD-10
H26.9
§ 02
How you might notice it
The key symptoms of Cataracts are: Gradual, painless, progressive blurring of vision over months to years that does not fully improve with glasses., Increased glare and halos around lights, particularly at night when driving or reading., Dimming or yellowing of colors — patients often report colors appearing 'faded' or 'duller' compared with the unaffected eye or with how they remember them., Difficulty reading small print despite previously functional reading glasses; frequent prescription changes that fail to maintain clear vision., Second-sight myopia: temporary improvement in near vision in nuclear sclerotic cataract — patients sometimes report being able to read without glasses for the first time in years, soon followed by further deterioration., Monocular diplopia (double vision in one eye) from refractive irregularity within the cataract., Difficulty driving at night because of headlight glare and inability to see contrast against bright lights..
01Gradual, painless, progressive blurring of vision over months to years that does not fully improve with glasses.
02Increased glare and halos around lights, particularly at night when driving or reading.
03Dimming or yellowing of colors — patients often report colors appearing 'faded' or 'duller' compared with the unaffected eye or with how they remember them.
04Difficulty reading small print despite previously functional reading glasses; frequent prescription changes that fail to maintain clear vision.
§ 03
How it’s diagnosed
diagnosis
Diagnosis of cataract is straightforward and based on history of progressive painless visual loss with characteristic slit-lamp examination findings. An ophthalmologist or optometrist examines the lens after dilating drops (tropicamide 1% or phenylephrine 2.5%) using a slit-lamp biomicroscope, which provides magnified illumination of the lens. The lens is graded using the Lens Opacities Classification System III (LOCS III) for nuclear color, nuclear opalescence, cortical, and posterior subcapsular changes, providing standardized documentation and progression tracking. Visual acuity is measured with a Snellen chart in standard illumination and with glare testing (brightness acuity testing, BAT) which often reveals greater visual impairment than Snellen alone. Contrast sensitivity testing (Pelli-Robson, CSV-1000) detects subtle disability that standard acuity misses. Color vision testing (Ishihara, Farnsworth D-15) documents the yellowing effect of nuclear sclerosis. Optical coherence tomography (OCT) of the macula and optic nerve is performed before cataract surgery to exclude coexisting macular pathology (macular degeneration, epiretinal membrane, diabetic macular edema) that would limit post-operative visual outcome. Intraocular pressure measurement excludes glaucoma. Biometry (optical or ultrasound) measures axial length, corneal curvature, and anterior chamber depth to calculate the appropriate intraocular lens power for surgery. Corneal topography or tomography assesses regular and irregular astigmatism for toric IOL selection. Endothelial cell count (specular microscopy) is performed in patients with corneal opacities or prior surgery. Once the cataract is significant enough to limit lifestyle, work, or driving, surgery is offered. There is no specific 'visual acuity threshold' — surgery is offered based on functional impact, not a fixed Snellen line.
✓Updated glasses prescription and lifestyle adjustments
✓Topical corticosteroids (post-operative)
✓Topical NSAIDs (post-operative)
✓Topical antibiotics (post-operative)
surgical options
Phacoemulsification with foldable IOL implantationOver 95% achieve 6/12 (20/40) or better visual acuity in eyes without coexisting pathology; serious complication rate under 2%
Femtosecond laser-assisted cataract surgery (FLACS)Equivalent visual outcomes to conventional phacoemulsification; slightly faster recovery in some metrics (FACT trial Day Ophthalmology 2016, PMID 27425031)
Extracapsular cataract extraction (ECCE) and manual small-incision cataract surgery (MSICS)Visual outcomes nearly comparable to phaco; cost-effective in resource-limited settings
Nd:YAG laser capsulotomyRestoration of clear vision in over 95% of treated patients; complications (retinal detachment, IOL damage) rare
§ 05
Causes & risk factors
known causes
Age-related oxidative damage to lens proteins
Cumulative ultraviolet and oxidative damage to crystallins (the main lens proteins) produces protein cross-linking, aggregation, and loss of transparency. This is the dominant cause of cataract — more than 90% of cataracts are age-related, with prevalence rising sharply over age 60.
Ultraviolet (UV) light exposure
Cumulative UV-B exposure across the lifespan accelerates cataract formation. Outdoor occupational exposure (fishermen, farmers, construction workers) and equatorial residence increase risk. UV-blocking sunglasses and broad-brimmed hats reduce cumulative dose.
Diabetes mellitus
Hyperglycemia accelerates cataract formation through the polyol pathway (glucose -> sorbitol accumulation in the lens, causing osmotic swelling and protein damage). Type 1 and type 2 diabetes both raise cataract risk, with onset 10-20 years earlier than age-matched controls.
Long-term corticosteroid use causes posterior subcapsular cataract dose-dependent and reversible-only with discontinuation in early stages. Long-term high-dose systemic corticosteroid, inhaled corticosteroid above 800 µg fluticasone equivalent/day, and topical ocular steroids are recognized risks.
Ocular trauma and intraocular surgery
Blunt ocular trauma can cause Vossius ring, lens dislocation, or rapidly developing cataract. Penetrating injury with lens capsule violation produces acute cataract within days. Prior pars plana vitrectomy accelerates nuclear sclerotic cataract in over 80% of patients within 2 years.
Smoking and alcohol
Cigarette smoking approximately doubles cataract risk in a dose-dependent manner. Heavy alcohol consumption is independently associated with cataract risk.
Genetic and metabolic causes (congenital and early-onset cataract)
02Wear a broad-brimmed hat outdoors to further reduce UV exposure.
03Stop smoking — risk reduction begins immediately and accumulates over years.
04Maintain tight glycemic control if you have diabetes (HbA1c target individualized).
05Minimize use of long-term systemic, inhaled, and topical corticosteroids where possible; use lowest effective dose.
06Wear protective eyewear during occupational, recreational, and DIY activities that risk eye injury.
07Eat a balanced diet with antioxidant-rich foods (vegetables, fruit, fish).
08Have regular eye examinations every 1-2 years over age 50 to detect early cataract and other eye disease.
recommended foods
§ 07
When to seek help
why see an ophthalmology
Diagnosis and surgical management of cataracts is the province of ophthalmology. An optometrist or general ophthalmologist makes the initial diagnosis; cataract surgery is performed by an ophthalmologist with subspecialty training in cataract and refractive surgery. Pediatric cataract requires referral to pediatric ophthalmology. Patients with coexisting glaucoma, retinal disease, or corneal disease benefit from combined subspecialty input.
01Posterior capsule opacification (PCO) — most common late complication; 20-40% within 5 years; treated with Nd:YAG laser capsulotomy.
02Endophthalmitis — rare (0.05-0.1%) but devastating intraocular infection; managed with vitreous tap and intravitreal antibiotics, sometimes vitrectomy.
03Posterior capsule rupture during surgery (1-3% in routine cases; higher in complex cases) — may require vitrectomy and altered IOL placement.
04Cystoid macular edema (CMO) — 1-2%; treated with topical and intraocular anti-inflammatory therapy.
05Retinal detachment — 0.5-1% over 10 years; higher in highly myopic eyes.
Nuclear sclerotic cataractMost common age-related cataract. Yellowing and darkening of the central lens nucleus producing gradual blurred vision, second-sight myopia (transient improvement in near vision before further progression), and difficulty distinguishing colors. Surgery is timed by visual symptoms and lifestyle impact.
Cortical cataractSpoke-like or wedge-shaped opacities in the lens cortex radiating from the equator into the visual axis. Causes glare and difficulty seeing in bright sunlight or with headlights at night. Surgery timed by visual symptoms.
Posterior subcapsular cataract (PSC)Plaque-like opacity beneath the posterior lens capsule, in the visual axis. Disproportionately impairs reading and near vision and produces marked glare. Often appears at younger ages; accelerated by corticosteroid use, diabetes, and radiation exposure. Often requires earlier surgery.
Anterior subcapsular and mixed cataractsAnterior subcapsular opacities (less common) and combinations of nuclear, cortical, and subcapsular changes (mixed) account for a substantial proportion of clinical cataracts.
Congenital cataractPresent at birth, occurring in roughly 1-3 per 10,000 live births. Causes include autosomal dominant genetic mutations (CRYAA, CRYAB, GJA8 etc.), intrauterine infections (rubella, cytomegalovirus, toxoplasmosis, herpes simplex), metabolic disease (galactosemia, Lowe syndrome), and trisomy 21. Early surgery within weeks of birth is critical to prevent deprivation amblyopia.
Traumatic cataractDevelops after blunt or penetrating ocular trauma. Can present acutely (rapid lens hydration and opacification) or chronically (months to years later). Often involves capsular rupture and zonular weakness that complicate surgery.
Iatrogenic and metabolic cataracts
Living with Cataracts
Timeline
Immediate post-operative recovery: vision often improves within hours; return home same day. Day 1: substantial visual improvement in most patients. Week 1: vision continues to improve and stabilize; eye drops continue. Week 2: most activities can resume. Week 4-6: surgery considered fully healed; second eye surgery can be scheduled. Final refractive outcome and glasses prescription typically stable by 6 weeks. PCO if it occurs is treated with Nd:YAG laser at any later time.
Lifestyle
01Update glasses prescription regularly as cataract progresses.
02Use bright reading lights and anti-glare measures for evening activities.
03Wear sunglasses outdoors, especially during the day when symptoms are worst.
04Limit night driving if glare is significant; consider day-driving only.
05Plan cataract surgery before vision impairment causes accidents, falls, or loss of independence.
06Manage diabetes, blood pressure, and other systemic conditions before and after surgery.
07Disclose all medications (especially alpha-blockers such as tamsulosin, which can cause intraoperative floppy iris syndrome) before surgery.
Daily management
01
Complementary approaches
Anti-cataract eye drops (lanosterol, others)Investigational topical lanosterol has shown preclinical and small clinical evidence of partial reversal of lens opacity but has not been validated in large trials. No anti-cataract eye drop is currently approved by regulatory authorities and surgical treatment remains the only effective intervention.
Optical aids and lifestyle adaptationsMagnifiers, increased illumination, large-print materials, and anti-glare strategies maintain function in patients who are not yet ready for surgery or who decline surgery.
Choosing a doctor
Choose an ophthalmologist who performs at least 200 cataract operations per year and reports outcomes (visual acuity, complication rates, refractive accuracy). Look for board certification, fellowship training in cataract and refractive surgery for complex cases, and use of modern equipment (femtosecond laser, advanced biometry, premium IOLs as needed). For pediatric cataract, choose a pediatric ophthalmologist.
Aravind Eye Care System →World's largest high-volume eye care provider; major contributor to global cataract surgery scale-up.
§ 08
Frequently asked
What is a cataract?▾▴
A cataract is a clouding of the natural lens of the eye, the biconvex transparent structure behind the iris that focuses light onto the retina. It causes painless progressive blurring of vision, glare, dimming of colors, and difficulty with reading and night driving. Cataract is the leading cause of treatable blindness worldwide.
What causes cataracts?▾▴
Most cataracts are caused by age-related changes to lens proteins after years of UV exposure and oxidative stress. Other causes include diabetes (especially uncontrolled), corticosteroid use (systemic, inhaled, topical, or intraocular), ocular trauma, prior intraocular surgery (especially vitrectomy), smoking, family history, and genetic mutations in congenital cataract.
What are the symptoms of cataracts?▾▴
Symptoms include gradual painless blurring of vision, glare and halos around lights (worst at night), dimming or yellowing of colors, difficulty reading despite glasses, frequent prescription changes, monocular double vision, and reduced contrast. Dense cataract appears as a visibly cloudy pupil. In children, a white pupil reflex requires urgent ophthalmology referral.
How are cataracts diagnosed?▾▴
Diagnosis is straightforward by an eye examination with pupil dilation and slit-lamp biomicroscopy. Visual acuity, glare testing, contrast sensitivity, optical coherence tomography (OCT), corneal topography, and biometry (for IOL calculation) complete the workup before surgery. No blood test is needed.
Can cataracts be cured without surgery?▾▴
No. There is no medication, eye drop, or non-surgical treatment that reverses or removes established cataract. Surgery is the only effective treatment for visually significant cataract. Conservative management with updated glasses and anti-glare measures supports function in early disease before surgery is indicated.
When should I have cataract surgery?▾▴
Surgery is offered when cataract significantly affects your quality of life — driving, reading, work, hobbies, or independence. There is no specific visual acuity threshold; the decision is patient-centred. Waiting too long can risk complications (lens-induced glaucoma, harder surgery in mature cataract); operating too early gains little.
Is cataract surgery painful?▾▴
No. Cataract surgery is performed under topical or peribulbar anesthesia and is virtually painless. Patients feel pressure or mild discomfort but no sharp pain. Light sedation is used for anxious patients. Recovery is typically rapid with mild gritty sensation or watering for 1-3 days after surgery.
How long does cataract surgery take?▾▴
Phacoemulsification cataract surgery typically takes 15-30 minutes per eye. Including pre-operative preparation, anesthesia, and post-operative observation, the total visit is 2-4 hours. Most cataract surgery is performed as a day-case procedure with discharge the same day.
What is phacoemulsification?▾▴
Phacoemulsification is the standard modern cataract surgery technique. A 2.2-3.0 mm corneal incision is made, the anterior lens capsule is opened (capsulorhexis), the lens nucleus is fragmented and aspirated with ultrasonic energy, and a foldable intraocular lens is inserted into the capsular bag. Day-case under topical anesthesia.
What is an intraocular lens (IOL)?▾▴
An intraocular lens (IOL) is an artificial lens implanted in the eye to replace the natural lens during cataract surgery. Options include monofocal IOLs (excellent distance or near vision but glasses needed for the other range), multifocal IOLs (distance plus near with some glare), toric IOLs (correct astigmatism), and extended depth of focus (EDOF) IOLs (intermediate vision with fewer glare effects).
How long is recovery from cataract surgery?▾▴
Most patients see substantial improvement within 24 hours of surgery and resume normal activities within 1 week. Eye drops continue for 3-4 weeks. Driving is usually allowed within a few days; heavy lifting and swimming should be avoided for 2 weeks. Full healing typically by 4-6 weeks; second-eye surgery can be scheduled then.
Will I still need glasses after cataract surgery?▾▴
With monofocal IOLs (the standard), most patients need glasses for either near or distance vision (the one not corrected). With multifocal or EDOF IOLs, many patients function without glasses for most activities but may have reduced contrast or some glare. With toric IOLs, astigmatism is corrected. The right choice depends on lifestyle and refractive needs.
Is cataract surgery safe?▾▴
Yes. Cataract surgery is one of the most successful and safest surgeries performed. Over 95% achieve good visual outcomes. Serious complications are rare: endophthalmitis 0.05-0.1%, posterior capsule rupture 1-3%, retinal detachment around 1%, cystoid macular edema 1-2%. Risks rise modestly in complex cases.
What is posterior capsule opacification?▾▴
Posterior capsule opacification (PCO) is the most common late complication of cataract surgery — clouding of the lens capsule that holds the IOL, developing in 20-40% of patients within 5 years. It produces gradual blurring of vision and is easily treated with Nd:YAG laser capsulotomy as a 5-minute painless outpatient procedure.
Can cataracts come back after surgery?▾▴
The cataract itself cannot return because the natural lens is removed. However, posterior capsule opacification can develop in the remaining lens capsule, producing similar symptoms; it is treated with Nd:YAG laser capsulotomy. After laser treatment, vision typically remains clear permanently.
Can both eyes have cataract surgery at the same time?▾▴
Bilateral same-day cataract surgery is performed at some centres for selected patients, particularly during the COVID-19 pandemic and for highly motivated patients. Most surgeons still recommend separating the two eyes by 1-6 weeks to verify outcomes, manage any complications, and stage anesthesia. Same-day surgery and staged surgery have similar outcomes in published series.
Is laser cataract surgery better than standard surgery?▾▴
Femtosecond laser-assisted cataract surgery (FLACS) uses laser for some steps (corneal incision, capsulorhexis, lens fragmentation) and adds cost. Randomized trials including FACT (2016) show similar visual outcomes and complication rates to conventional phacoemulsification. FLACS offers some procedural advantages in selected cases; it is not categorically 'better'.
Can I have cataract surgery if I have other eye disease?▾▴
Yes. Patients with glaucoma, macular degeneration, diabetic retinopathy, or other eye disease can have cataract surgery — the cataract is the lens, not the retina. Coexisting eye disease may limit the visual outcome from cataract surgery, but removing the cataract still typically improves vision and enables better management of other conditions.
Do children get cataracts?▾▴
Yes. Congenital cataract affects approximately 3 per 10,000 live births and pediatric cataract develops in childhood. Causes include genetic mutations, intrauterine infections, metabolic disorders, and trauma. Urgent surgery within weeks of detection prevents deprivation amblyopia. Subsequent amblyopia therapy with patching is essential for visual development.
How can I prevent cataracts?▾▴
Wear UV-blocking sunglasses and broad-brimmed hats outdoors. Stop smoking. Control diabetes tightly. Minimize long-term corticosteroid exposure. Eat a balanced diet rich in antioxidants. Have regular eye examinations after age 50. No proven medication or supplement prevents cataract from developing.
How much does cataract surgery cost?▾▴
Cost varies widely by country, healthcare system, and IOL choice. In the UK NHS, surgery is free at point of use; premium IOLs (multifocal, toric, EDOF) may require private fees. In the US, Medicare and most insurance cover monofocal IOL surgery; premium IOLs incur out-of-pocket costs of $1,500-3,500 per eye. Globally, cost-effective high-volume programmes (Aravind, Sankara Nethralaya) deliver surgery at very low cost.
Second-sight myopia: temporary improvement in near vision in nuclear sclerotic cataract — patients sometimes report being able to read without glasses for the first time in years, soon followed by further deterioration.
06Monocular diplopia (double vision in one eye) from refractive irregularity within the cataract.
07Difficulty driving at night because of headlight glare and inability to see contrast against bright lights.
08A visibly cloudy, gray, or yellowish pupil in dense or mature cataract — visible to others.
09Reduced contrast sensitivity that makes faces, edges, and low-light environments harder to discern despite measured Snellen visual acuity being only modestly impaired.
10Falls, dropped items, and reduced confidence in mobility in older adults with bilateral cataract.
11White or asymmetric pupil reflex (leukocoria) in pediatric cataract — requires urgent ophthalmology referral to exclude retinoblastoma and other serious causes.
early warning signs
•Frequent changes in glasses prescription that fail to provide clear vision in middle-aged or older adults
•Increasing glare while driving at night and avoidance of night driving
•Difficulty reading small print, telephone screens, and menus in dim light
•Subjective sense that one eye is 'dimmer' or that colors look different between the two eyes
•Leukocoria (white pupil reflex) in an infant — requires urgent ophthalmology referral
● emergency signs
•Sudden severe vision loss — exclude retinal detachment, vitreous hemorrhage, or other acute ocular emergency
•Severe eye pain with red eye, vomiting, and halos — exclude acute angle-closure glaucoma
•Sudden onset of floaters or flashing lights — exclude retinal tear or detachment
•Post-operative red painful eye with reduced vision — exclude endophthalmitis (rare but devastating complication, <0.1% of modern cataract surgery)
•Acute white pupil (leukocoria) in a child — exclude retinoblastoma, Coats disease, persistent fetal vasculature
Direct visualization of lens opacities and classification by LOCS III
03
Glare (brightness acuity) testingReveals visual impairment caused by glare that standard acuity testing misses
04
Optical coherence tomography (OCT) of the macula and optic nerveExcludes coexisting macular and optic nerve pathology that would limit post-operative visual outcome
05
Biometry (IOL Master, Lenstar, or A-scan ultrasound)Measures axial length, corneal curvature, and anterior chamber depth for accurate IOL power calculation
06
Corneal topography or tomography (Pentacam, OPD-Scan)Maps corneal astigmatism and detects irregular astigmatism; informs toric IOL selection and identifies subclinical keratoconus
07
Intraocular pressure measurement (Goldmann tonometry or non-contact)Excludes glaucoma which can affect visual outcomes and management approach
Outlook
The prognosis of cataract is excellent. With modern phacoemulsification surgery and high-quality intraocular lens implantation, over 95% of patients in the absence of coexisting ocular pathology achieve 6/12 (20/40) or better visual acuity, restoring driving vision and reading function. Patients with coexisting macular degeneration, diabetic retinopathy, glaucoma, or other eye disease have outcomes limited by the additional condition rather than by the cataract surgery itself. The most common late complication is posterior capsule opacification (PCO) developing in 20-40% within 5 years, easily treated with Nd:YAG laser capsulotomy. Endophthalmitis remains the most feared complication at 0.05-0.1% in modern series with intracameral antibiotic prophylaxis. Retinal detachment occurs in roughly 0.5-1% over 10 years post-cataract surgery, with higher risk in highly myopic eyes. Refractive outcomes have improved substantially with modern biometry — over 80% of patients achieve refractive accuracy within ±0.5 D of target. Pediatric cataract operated within weeks of detection followed by intensive amblyopia therapy can achieve good visual outcomes; delayed surgery (after 6 weeks for unilateral disease, beyond infancy for bilateral) results in permanent deprivation amblyopia. WHO and IAPB target cataract elimination as a leading cause of blindness through expanded surgical access and high-volume programmes such as Aravind, LV Prasad, and Sightsavers.
Mutations in crystallin genes (CRYAA, CRYAB, CRYBB1-3, CRYGC-D), connexin genes (GJA3, GJA8), and other lens structural genes cause autosomal dominant congenital cataract. Metabolic disorders (galactosemia, Lowe syndrome, Wilson disease, mannosidosis, Fabry disease) and intrauterine infections (rubella, CMV, toxoplasmosis) also cause pediatric cataract.
Radiation and chemical exposure
Ionizing radiation (radiotherapy fields including the eye, occupational exposures, atomic bomb survivors), microwave exposure, and intraocular chemical injuries can all cause cataract.
risk factors
Age 60 and oldernon-modifiable
By far the strongest risk factor. Prevalence rises from approximately 5% at age 50 to over 50% at age 80.
Cumulative UV light exposuremodifiable
Outdoor work, equatorial residence, and life-long sun exposure. UV-blocking sunglasses and hats reduce cumulative dose.
Diabetes mellitusmodifiable
Both type 1 and type 2 diabetes raise cataract risk; cataract typically appears 10-20 years earlier than in non-diabetics.
Cigarette smokingmodifiable
Doubles cataract risk in a dose-dependent manner. Smoking cessation reduces risk gradually.
Chronic corticosteroid usemodifiable
Systemic, inhaled, topical, and intraocular corticosteroids all increase cataract risk. Use the lowest effective dose and consider alternatives when possible.
Family history of cataractgenetic
Familial early-onset cataract suggests crystallin or other lens gene mutations; family history also contributes to age-related cataract susceptibility.
Prior intraocular surgery (vitrectomy)non-modifiable
Pars plana vitrectomy accelerates nuclear sclerotic cataract — over 80% of vitrectomy patients develop visually significant cataract within 2 years.
High myopia, high hyperopia, retinal disease requiring intraocular proceduresnon-modifiable
Highly myopic eyes have higher rates of nuclear cataract; eyes with prior surgery, glaucoma drainage devices, or chronic uveitis are at higher risk.
Nutritional deficiencymodifiable
Antioxidant deficiency (vitamin C, E, lutein, zeaxanthin) is associated with elevated cataract risk in some studies; balanced diet may slow progression.
•Lutein- and zeaxanthin-rich foods (spinach, kale, corn, eggs) — beneficial for general eye health
•Adequate hydration with water (especially in the postoperative period)
foods to avoid
•Excess alcohol — independently associated with cataract risk
•Smoking — strongly associated with cataract and other ocular disease
•Excess refined sugar in poorly controlled diabetes
•Aspirin in the immediate post-operative period unless required for cardiovascular reasons (small bleeding risk)
Suprachoroidal hemorrhage — rare; can cause major vision loss.
07Refractive surprise (post-operative refraction different from target) — managed with glasses, IOL exchange, or refractive enhancement.
08Glare, halos, dysphotopsia after multifocal or EDOF IOLs.
09Posterior segment complications in pre-existing macular or retinal disease.
10Failure of amblyopia therapy in pediatric cases despite successful cataract surgery.
choosing the right hospital
01Day-case surgical facility with cataract surgery infrastructure
02Modern phacoemulsification equipment and femtosecond laser (where available)
03Comprehensive optical biometry and corneal topography
04Pharmacy stocking range of monofocal, toric, multifocal, and EDOF IOLs
05Post-operative follow-up and refractive optometry services
Essential facilities
Tertiary ophthalmology centresDesignated high-volume cataract surgery programmes (Aravind, Sankara Nethralaya, LV Prasad, Sightsavers)Pediatric ophthalmology servicesASC (ambulatory surgery centres) with cataract surgeryWHO IAPB Vision Atlas designated programmes
vs. Cataracts
Age-related Hearing Loss (Presbycusis)
Both are age-related sensory deficits; they coexist commonly in older adults but affect different senses. Cataract affects vision; presbycusis affects hearing. The point of mentioning them together is that both are common reasons for falls and reduced independence in older adults and need coordinated assessment.
Compare →
Long-term systemic, inhaled, or topical corticosteroid use, diabetes mellitus (snowflake cataract), radiation exposure, prior intraocular surgery (vitrectomy), and metabolic disorders (galactosemia, Wilson disease) all produce characteristic cataract patterns.
Apply post-operative eye drops on the prescribed schedule (typically 4 times daily for 3-4 weeks for steroids and antibiotics).
02Avoid rubbing the operated eye; wear the protective shield at night for the first week.
03Attend post-operative follow-up at day 1, week 1, and week 4-6.
04Wear sunglasses outdoors after surgery for at least 2-4 weeks.
05Report any sudden vision loss, red painful eye, or new floaters immediately.
06Schedule second-eye surgery (if needed) typically 2-6 weeks after the first eye.
07Use prescribed reading glasses if monofocal IOL was placed for distance.
Exercise
Regular physical activity is encouraged. After cataract surgery, avoid heavy lifting (over 5-10 kg) for 1 week, swimming and saunas for 2 weeks, and contact sports for 4 weeks. Walking, light cycling, and gentle yoga can resume the day after surgery. Resume normal activity from 4 weeks with surgeon approval.