Eye Conditions in Older Adults: Cataracts

A clinically significant cataract is defined as an opacification of the eye lens causing a significant decrease in visual acuity or a functional visual impairment. Age-related cataracts are the leading cause of blindness in the world and one of the most common etiologies of visual impairment in the United States. Consequences can include loss of driving privileges, inability to read or watch television, inability to participate in social activities, and an increased risk of falls. In the United States, cataract surgery is the most commonly performed surgical procedure among older patients. There are three main types of cataracts: nuclear, cortical, and subcapsular. Age is the strongest predictor of cataract development. Other major risk factors include a family history of cataracts, diabetes, smoking, obesity, poor nutrition, lower socioeconomic status, and alcohol use. Surgery is the definitive treatment. Phacoemulsification and implantation of a posterior chamber intraocular lens is the most common method used for managing cataracts in the United States. Glasses or contact lenses then are prescribed to correct any residual refractive errors. Cataract surgery is a low-risk procedure and routine preoperative testing typically is not needed.