Dear Dr. Garner,
I had been having trouble with my vision so I went to see my ophthalmologist. She said I have cataracts that need to be removed. I am a little nervous about the surgery.  
Could you tell me more about this condition and why I got it?  I am in good condition otherwise.
Clouded Eyes in
Clinton Hill

Dear Clouded,
You might be surprised to learn that cataract surgery is actually the most common surgical procedure performed in America.
Let’s start with the basics: What is a cataract? Cataracts form when the lens of the eye becomes cloudy. More than half of Americans ages 65 and older have a cataract, and it is thought that nearly everyone will develop one if they live long enough.
The lens of the eye works much like a camera lens, focusing light onto the back of the eye on a structure called the retina.  The lens also adjusts the eye’s focus, letting us see things clearly both up close and far away. The lens is mostly made of water and a substance known as a protein.

Cataract Symptoms:

• Cloudy, blurred or dulled vision.
• Need for a brighter light to read.
• Increased sensitivity to glare (headlights, lamps or sunlight may seem too bright).
• Frequently needing to change your eyeglass/contact prescription.
As we age, some of the protein may clump together and start to cloud a small area of the lens.  This is a cataract, and over many years, it may grow larger and cloud more of the lens, making it harder to see.
Therefore, the main symptoms of a cataract are cloudy, blurred and dulled vision, which cannot be corrected by wearing stronger glasses or contact lenses. You may find the need for a brighter light to read. Increased sensitivity to glare may also be a problem.
There are also several types of cataracts; the most common is called a nuclear cataract, because it affects the inside of the lens. Another common form is a cortical cataract in which the outside of the lens becomes cloudy.
Risk Factors
Why do some people get cataracts at an earlier age than others?
Smoking greatly increases the chance of getting a nuclear cataract, the most common type in the United States. To lower the risk for cataracts, simply stop smoking.
Diabetes is another risk factor for developing cataracts.  Keeping blood sugar under tight control and maintaining a normal weight can slow this.
Many studies suggest that exposure to ultraviolet light is associated with cataract development, so it is advised to wear sunglasses and a hat to lessen exposure.
An interesting study, conducted in Iceland in 2005, suggests that airline pilots have a higher risk of developing cataracts than non-pilots. It is thought this is due to exposure to cosmic radiation. A similar theory suggests that astronauts, too, are at increased risk from cosmic radiation.
People who use steroids are also more prone to cataracts.  Some eye care experts believe that a diet high in antioxidants, such as beta-carotene (vitamin A) selenium and vitamin C and E, may slow down the development of cataracts. While this is not proven, it is always good to get as many of these vitamins in their natural form, in food, as opposed to pills. Heavy alcohol consumption is a risk factor as well.
Now that we have reviewed the symptoms and some possible causes, what are the treatments available?
Effective Treatment
Cataracts are a curable eye condition. The surgery performed is rapid, safe and nearly always completely successful.  Nine out of 10 people who have cataract surgery regain very good vision.
A cataract needs to be removed only if it interferes with one’s vision enough to prevent him/her from driving, reading or other essential activities. After the surgery, an artificial lens is implanted in the eye so that people no longer need to wear “Coke-bottle” glasses.
Remember, however, that just having a cataract does not mean you need immediate surgery. When symptoms begin to appear, you may be able to improve your vision for a while using new glasses, appropriate lighting or magnification.
Many people consider poor vision an inevitable fact of aging, but cataract surgery is a simple, relatively painless procedure to regain regular vision.
I urge you and any of our other readers who are exhibiting signs of vision problems to check with your doctor to determine the cause. If cataracts are to blame, find out how your quality of life can be improved with this surgical procedure.

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Dr. Steven Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on The NET, Tuesdays at 8 p.m. on Channel 97 Time Warner and Channel 30 Cablevision.