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Untreated Cataracts: What Happens As They Progress

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Most often, cataracts require surgery to remove them, but some people never need cataract surgery.

If left untreated, your eye doctor will monitor your cataracts regularly, keeping an eye on the rate of progression. If things reach a certain point, surgery will be recommended.

Cataract surgery can be accomplished through laser-assisted technology that removes the cloudy lens and replaces it with an artificial clear one. Cataract surgery is considered safe, and it is a common treatment for improving vision related to cataracts.

While a small number of people may never need cataract surgery, most people with cataracts will eventually need to have them removed via surgery.

Progression of Cataracts

StageClouding of LensVision ImpairmentSymptoms
Early StageMinimalMildBright lights may seem glaring, colors less vibrant
Intermediate Stage
Moderate		ModerateBlurred or hazy vision, difficulty reading or seeing at night
Advanced Stage
Significant		SevereSubstantial loss of vision, difficulty performing regular activities, potential double vision
Severe/Hypermature StageCompleteBlindnessLens may appear white, potential for pain and inflammation if secondary glaucoma occurs

Cataracts can be unpredictable, and they can progress at variable rates. In general, if a cataract is age-based though, meaning that the clouding of lens is purely due to age and not because of an injury or illness, the cataract is liable to progress rather slowly. This can give you time to decide on the right course of treatment and determine if and when surgery is the best course of action.

Cataracts are often a natural part of aging, as the proteins bind together and cause cloudiness on the lens that impairs vision.

The National Eye Institute publishes that age-related cataracts can form in a person’s 40s or 50s, but they generally progress slowly enough that they do not start to really impair vision until age 60 or so. The proteins may start clumping together to form a small cataract around middle age; however, the cataract doesn’t get big enough to cause vision problems for several more years.

You can delay the onset and slow the progression of cataracts by protecting your eyes from ultraviolet light. Wear sunglasses and/or a hat with a brim while out in the sun to keep the sunlight out of your eyes.

Cataracts that are related to injury or illness or that occur in a younger age can progress more quickly than age-related cataracts. The following can increase the risk for cataracts and be a contributing factor to their onset:

  • Illness such as diabetes
  • Use of some medications like corticosteroids
  • Injury to the eye
  • Surgery on the eye
  • Radiation treatments, especially on the upper body
  • Family members who suffer from cataracts
  • Smoking
  • Poor nutrition and obesity
  • Excessive alcohol consumption
  • Extended and unprotected exposure to ultraviolet sunlight

Dangers of Untreated Cataracts

Left untreated, cataracts can lead to vision impairment, vision loss, and even blindness.

In fact, the World Health Organization (WHO) reports that cataracts are the number one cause of blindness in the world. The Centers for Disease Control and Prevention (CDC) publishes that in the United States, cataracts are the biggest culprit for vision loss.

Cataracts often progress very slowly as the proteins clump together; however, if there is trauma, illness, if the eye (and body) is not properly cared for, or if the eye is exposed to sunlight, smoking, radiation, or certain medications, cataracts can form faster and require quicker intervention.

Cataracts can form in one eye or both, and they can progress differently in each as well. One eye may be worse than the other or progress faster, for instance.

Without treatment, cataracts can get large enough to impair vision completely. They can lead to vision loss and total blindness in some cases.

How Long Does It Take to Go Blind from Cataracts?

Cataracts’ progression can be quite variable and depends on several factors including the type of cataract, age, overall health, and lifestyle of the individual. Age-related cataracts typically develop slowly, often taking several years or even decades to reach a stage where they significantly affect vision. In some cases, it could take 10 years or more for a cataract to progress to the point of causing blindness.

However, other types of cataracts, such as those due to diabetes, trauma or certain medications can progress more quickly. These might lead to significant vision impairment in a matter of months or a few years. It’s essential to note that ‘blindness’ from cataracts usually refers to severe vision loss but doesn’t mean total darkness. Even in advanced stages, most individuals with cataracts can perceive light and shadows.

Remember, cataracts are a treatable cause of blindness. Regular eye exams and timely intervention can prevent vision loss due to cataracts.

The Ease of Cataract Surgery

Cataract surgery is a common and safe procedure that can replace the cloudy lens with a new artificial and clear lens. This is often accomplished through laser-assisted technology.

An intraocular lens (IOL) is used to replace the lens of the eye. The artificial lens implant generally improves and restores vision.

In 2021 and beyond, cataract surgery is considered very safe and effective. Your ophthalmologist can help you to determine if cataract surgery is right for you.

References

  1. Eye Health Statistics. (2015). American Academy of Ophthalmology.
  2. What Are Cataracts? (September 2021). American Academy of Ophthalmology.
  3. Facts About Cataracts. (August 2019). National Eye Institute.
  4. Cataracts. (June 2018). Mayo Clinic.
  5. Priority Eye Diseases. World Health Organization.
  6. Common Eye Disorders. (June 2020). Centers for Disease Control and Prevention.
  7. Cataract Surgery. (March 2018). Mayo Clinic.
  8. Optimization of Cataract Surgery Follow-Up: A Standard Set of Questions Can Predict Unexpected Management Changes at Postoperative Week One. (September 2019). PLOS ONE.

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