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Causes

By Mayo Clinic staff

Most cataracts develop when aging or injury changes the tissue that makes up your eye's lens. Some cataracts are caused by inherited genetic disorders that cause other health problems and increase your risk of cataracts.

How a cataract forms
The lens, where cataracts form, is positioned behind the colored part of your eye (iris). The lens focuses light that passes into your eye, producing clear, sharp images on the retina — the light-sensitive membrane on the back inside wall of your eyeball that functions like the film of a camera. A cataract scatters the light as it passes through the lens, preventing a sharply defined image from reaching your retina. As a result, your vision becomes blurred.

As you age, the lenses in your eyes become less flexible, less transparent and thicker. Aging-related changes to the lens cause tissues to break down and to clump together, clouding small areas of the lens. As the cataract continues to develop, the clouding becomes denser and involves a greater part of the lens.

A cataract can develop in one or both of your eyes.

Types of cataracts
Cataract types include:

  • Cataracts that affect the center of the lens (nuclear cataracts). A nuclear cataract may at first cause you to become more nearsighted or even experience a temporary improvement in your reading vision. But with time, the lens gradually turns more densely yellow and further clouds your vision. Nuclear cataracts sometimes cause you to see double or multiple images. As the cataract progresses, the lens may even turn brown. Advanced yellowing or browning of the lens can lead to difficulty distinguishing between shades of color.
  • Cataracts that affect the edges of the lens (cortical cataracts). A cortical cataract begins as whitish, wedge-shaped opacities or streaks on the outer edge of the lens cortex. As it slowly progresses, the streaks extend to the center and interfere with light passing through the center of the lens. Problems with glare are common for people with this type of cataract.
  • Cataracts that affect the back of the lens (posterior subcapsular cataracts). A posterior subcapsular cataract starts as a small, opaque area that usually forms near the back of the lens, right in the path of light on its way to the retina. A subcapsular cataract often interferes with your reading vision, reduces your vision in bright light and causes glare or halos around lights at night.
  • Cataracts you're born with (congenital cataracts). Some people are born with cataracts or develop them during childhood. Such cataracts may be the result of the mother having contracted an infection during pregnancy. They may also be due to certain inherited syndromes, such as Alport's syndrome, Fabry's disease and galactosemia. Congenital cataracts, as they're called, don't always affect vision, but if they do they're usually removed soon after detection.
References
  1. Cataract: What you should know. National Eye Institute. http://www.nei.nih.gov/health/cataract/webcataract.pdf. Accessed April 12, 2010.
  2. Care of the adult patient with cataract. St. Louis, Mo.: American Optometric Association. http://www.aoa.org/documents/CPG-8.pdf. Accessed April 12, 2010.
  3. Wevill M. Epidemiology, pathophysiology, causes, morphology, and visual effects of cataract. In: Yanoff M, et al. Ophthalmology. 3rd ed. Philadelphia, Pa.: Mosby; 2008. http://www.mdconsult.com/das/book/body/194686199-3/0/1869/0.html. Accessed April 12, 2010.
  4. Cataract in the adult eye. American Academy of Ophthalmology. http://one.aao.org/asset.axd?id=821cecfb-85c5-400d-a65f-7a9a727bc163. Accessed April 12, 2010.
  5. Acquired cataract. In: Ehler JP, et al. The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 5th ed. Baltimore, Md.: Lippincott Williams & Wilkins; 2008. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&NEWS=N&PAGE=booktext&D=books&AN=01337416/5th_Edition/3&XPATH=/OVIDBOOK%5b1%5d/METADATA%5b1%5d/TBY%5b1%5d/EDITORS%5b1%5d. Accessed April 14, 2010.
  6. Guercio JR, et al. Congenital malformations of the eye and orbit. Otolaryngologic Clinics of North American. 2007;40:113.
  7. Abel R. Cataract. In: Rakel D. Integrative Medicine. 2nd ed. Philadelphia, Pa.: Saunders Elsevier; 2007. http://www.mdconsult.com/das/book/body/194686199-3/0/1494/0.html. Accessed April 12, 2010.
  8. Robertson DM (expert opinion). Mayo Clinic, Rochester, Minn. April 24, 2010.
DS00050 May 20, 2010

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