Most patients with early cataracts may not have a lot of symptoms. As cataracts worsen, many people will complain of increased glare while driving at night, the fact that colors look muddied or washed out, or that things just don’t look as sharp as they used to. It is not uncommon for patients’ glasses prescriptions to change as cataracts develop, and the treatment for early cataracts is often to just prescribe a new pair of glasses.
Many patients do not notice that their cataracts worsen for two reasons. First, cataracts develop slowly so their effects on a person’s vision is gradual and not very dramatic. Second, cataracts most often affect the lenses in a person’s two eyes similarly, so when they compare the vision in one eye to the other, they often cannot tell that anything is amiss. For these reasons, we recommend everyone have a full, dilated eye examination every year starting around age 55.
Patients will often ask me about when their cataracts will become “ripe”. The concept of a “ripe” cataract goes back to the type of surgery that was done in the mid-1900’s. At that time, the cataractous lens was removed from the eye as a single, intact piece, like removing the pit from an avocado. It was beneficial for the cataract to be very hard so that the surgeon could remove it without it breaking up into small pieces, and the term “ripe” was adopted for this reason.