Blurry words on a menu. Headlights that scatter into blinding halos. Washed-out colours on the TV. These are signs of cataracts. But what keeps many people from seeking treatment isn’t just the cloudy vision; it’s the misconceptions and fear that come with it.
Some people are told to wait until a cataract “ripens.” Others picture surgery as a long, painful ordeal. Cataracts, however, are highly treatable, and modern surgery is one of the safest and most common procedures performed worldwide. Because myths and worries remain, many continue living with cloudy vision, assuming it’s simply part of getting older.
The scale of the issue
Cataracts are the leading cause of blindness worldwide, officially recognised by the World Health Organization. According to WHO, refractive errors and cataracts remain the two major drivers of vision impairment globally.
Global studies estimate that more than 90 million people aged 50 and older live with vision loss from cataracts that could be corrected through surgery. Myths, fear and lack of access keep many in blurred vision for years before they seek help.
In Asia-Pacific, the issue is even more pressing. Rapid ageing, widespread misconceptions about surgery, and limited access to regular eye checks mean treatment is often delayed until sight is severely affected.
How cataracts affect vision
Doctors often describe cataracts as like looking through a fogged-up window. People living with cataracts usually explain it more simply: everything looks dimmer. Words blur, colours fade, and lights at night scatter into glare.
Most cataracts develop with age, but ageing isn’t the only factor. Too much sun without sunglasses or UV-blocking lenses, smoking, diabetes, certain medications, or even past injuries can make them appear earlier.
While cataracts are most often linked to ageing, ophthalmologist Dr Mohan explains that lesser-known risk factors can trigger earlier onset. “Although increasing age remains the most common cause, several additional factors can accelerate cataract formation, even in younger individuals.”
- Lifestyle habits such as smoking and excessive alcohol intake contribute to oxidative damage within the lens.
- Ultraviolet (UV) exposure, particularly without protective eyewear, increases risk.
- Chronic medication use, especially long-term corticosteroids like prednisolone, can lead to premature cataracts.
- Systemic health conditions, including diabetes, obesity, and other pro-inflammatory disorders, further heighten susceptibility.
- Previous eye trauma or surgery may also compromise the lens and hasten cataract development.
Recognising and addressing these modifiable risks, Dr Mohan stresses, is a crucial step in preventive eye care.
The everyday signs
Cataracts develop slowly, with signs that are easy to miss at first:
- Menus in dim restaurants or cafes become impossible to read, even with glasses.
- Headlights at night scatter into blinding halos, making driving feel unsafe.
- Colours on screens, clothes, or photos seem faded, less vivid than you remember.
- Extra lights get switched on earlier in the evening just to scroll, read, or work comfortably.
Cataracts typically develop gradually, and in the early stages their symptoms are often overlooked or mistaken for natural ageing or the need for a new prescription. Some of the most common warning signs include:
- Blurry, cloudy, or hazy vision
- Glare or halos around lights, particularly noticeable at night
- Increased sensitivity to light
- Fading or yellowing of colours
- Frequent changes in eyeglass prescriptions
If these changes occur, a comprehensive eye examination is recommended. Identifying cataracts early allows for closer monitoring and can support better planning should surgery be required later on.
How to describe your symptoms to your doctor?
A common mistake is telling the doctor simply, “My eyesight is bad.” That doesn’t give enough detail. Doctors need to know what you see, when you see it, and how it affects your daily life. These details help them confirm whether cataracts are the cause, how advanced they may be, and whether treatment or surgery is needed.
Don’t worry about using medical terms. Simple, everyday examples such as “I can’t read the menu in dim lighting” or “Headlights make it impossible for me to drive at night” are often the most useful.
While there is currently no treatment to reverse cataracts, Dr Mohan advises that certain strategies can help slow their progression:
- Consistent use of UV-protective sunglasses
- Good diabetic control for patients with diabetes
- A diet rich in antioxidants, including leafy greens, berries, carrots, and omega-3-rich fish
- Avoid smoking
- Limit alcohol intake
Once cataracts begin to interfere with daily activities, surgery remains the only definitive and effective treatment.
Why regular check-ups matter
The danger with cataracts is not how fast they progress, but how gradually. Many people don’t realise how much sight they’ve lost until everyday tasks become challenging: reading, driving, or recognising a face.
So what actually happens in an eye check-up?
Reading letters from a chart at different sizes.
A special microscope with attached bright light that lets the doctor examine the different parts of the eye.
Eye drops are used to widen the pupil, allowing the doctor to examine the back of the eye.
The process is painless, usually takes less than 30 minutes, and can detect cataracts in their early stages. Yet many skip it because they assume changing glasses is enough, or because they fear being told they need surgery.
When cataracts develop alongside other eye conditions, management becomes more complex and requires an individualised approach. These co-existing diseases can influence the timing of surgery, the surgical technique, lens selection, and ultimately the visual outcome.
Conditions that can complicate surgery include:
-
Diabetic retinopathy
- Cataracts may obscure a clear view of the retina
- Macular oedema may limit vision recovery after surgery
-
Glaucoma
- Alters intraocular pressure dynamics
- Visual field loss persists even after cataract removal
- Some glaucoma medications may increase surgical complexity
-
Age-related Macular Degeneration (AMD)
- Limits central vision
- Premium lens options often offer little added benefit
-
Uveitis (Inflammatory eye disease)
- Inflammation must be well-controlled before surgery
- Higher risk of complications such as cystoid macular oedema
- Requires careful IOL selection and postoperative care
Other considerations include:
- Keratoconus Irregular corneal shape complicates IOL power calculations
- Corneal dystrophies or scars May increase the risk of postoperative corneal oedema
- High myopia or hyperopia Greater risk of retinal complications and challenging lens calculations
- Previous refractive surgery (e.g. LASIK) Complex IOL power calculations requiring advanced biometric techniques
- Retinal vein occlusions May limit visual improvement post-surgery
- Optic nerve damage (e.g. glaucoma, ischaemia) Can cause persistent vision loss despite surgery
- Amblyopia Visual potential is limited, but surgery may still improve function
- Prior eye surgery or trauma May require advanced tools such as capsular tension rings or scleral fixation
While cataract surgery is highly effective, patients with co-existing ocular conditions should understand that outcomes can vary. A comprehensive preoperative evaluation, clear expectation-setting, and tailored surgical planning are essential. In complex cases, collaborative care with retina, glaucoma, or cornea specialists may be required to achieve the best results.
What happens if you wait
Cataracts don’t disappear on their own. The clouding in the lens slowly worsens, causing vision to become increasingly blurred.
At first it may just mean squinting at signs. But over time, the effects are harder to ignore:
Driving at night becomes stressful. Glare from headlights and difficulty reading signs turning ordinary trips into real safety risks.
Poor vision increases the risk of falls and accidents, especially in dim or unfamiliar places.
Confidence often drops, and many start avoiding hobbies, social events, or even simple errands.
When cataracts are left until they are very advanced, surgery is still possible but can be more complicated than if treated earlier.
Cataract surgery today
For many, it’s the idea of surgery that makes them wait. The word brings to mind hospital beds, pain, and long recovery. But cataract surgery today is very different:
- Anaesthetic: Almost usually local, not general.
- Procedure: A tiny incision is made, the cloudy lens is broken up with ultrasound (phacoemulsification), and replaced with a clear artificial lens.
- Time: Often under 30 minutes.
- Recovery: Most patients go home the same day and notice improvement within days.
Complications are uncommon, and today’s intraocular lenses can also correct near-sightedness or astigmatism.
Dr Mohan explains that advances in cataract surgery and intraocular lenses (IOLs) have transformed vision correction into a highly personalised procedure. In addition to removing the clouded lens, patients can now choose from a range of IOL options tailored to their visual needs and lifestyle:
Monofocal IOLs- Correct vision at a single distance, usually far
- Cost-effective and highly reliable
- Glasses are still required for near work
- Provide both distance and near vision
- Reduce dependence on glasses
- May cause glare or halos, particularly at night
- Offer a continuous range of vision from far to intermediate
- Cause fewer night vision disturbances than multifocals
- Well-suited for computer users and active individuals
- Specifically correct astigmatism
- Available in monofocal, multifocal, and EDOF variants
- Allow postoperative fine-tuning of vision using UV light treatments
- Ideal for patients seeking the most precise outcome
Lens selection is ultimately a shared decision between patient and surgeon, guided by overall eye health, occupation, lifestyle, and visual goals.
The challenge with cataracts is not the availability of treatment since surgery today is safe and effective, but the myths and fears that stop people from seeking help. Too often, poor vision is accepted as an unavoidable part of ageing, even when it doesn’t have to be.
When the topic stays unspoken, many seniors adapt in silence. They give up night driving, skip social gatherings, or brush off the blur on their phone screen as nothing serious. Over time, these small changes add up, limiting mobility and independence.
An eye check is a simple first step. Sometimes all it takes is a gentle word from a son, daughter, or grandchild to start the conversation. For many families, that nudge restores not only clearer sight, but also the confidence to stay active and connected.
Dr Sashwanthi Mohan
Specialist, Ophthalmologist, Cataract & Vitreoretina
Medcare Eye Centre, Al Safa, UAE
Instagram: @medcareae
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