Cataracts: Symptoms, Causes & Treatment

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Cataracts are common, especially as we get older. They occur when the eye’s normally clear lens becomes cloudy, which can gradually affect your vision.

You may notice misty vision, faded colours or increased sensitivity to bright lights. These changes often develop slowly, so they may not be obvious at first.

If you’re concerned about your vision or think you could have cataracts, an eye test is a sensible place to start. An optometrist can examine your eyes, discuss your symptoms and advise whether you need further care.

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What is a cataract?

A cataract is when the natural lens inside your eye becomes cloudy. The lens sits behind the iris and helps focus light onto the retina at the back of your eye. As the lens becomes less clear, light doesn't pass through it as effectively, which can affect the quality of your vision.

Cataracts usually develop gradually rather than appearing suddenly. They can affect one or both eyes, and one eye may be affected more than the other.

Cataracts are particularly common as we get older, but they can develop for other reasons too. Having a cataract doesn't necessarily mean you'll have significant problems with your sight straight away.

What does vision look like with cataracts?

It’s important to remember that people experience cataracts in different ways. If you start to experience cataract symptoms, you might describe your vision as:

- Blurry or cloudy, even when you're wearing the right prescription

- Misty or foggy, as though you're looking through a steamed-up window

- Dimmer than it used to be

- Less clear in low light or at night

- More affected by glare from bright lights

- Less able to distinguish colours clearly

You may also notice that your glasses prescription seems to need changing more often without giving you the improvement in vision you were expecting.

These symptoms can have other causes too, so they don't necessarily mean you have cataracts. If your vision has changed, an eye test can help you understand what might be happening.

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What are the symptoms of cataracts?

Cataract symptoms usually develop gradually. Because they don't normally cause pain, you may not notice the changes immediately.

Common symptoms of cataracts include:

- Blurred, cloudy or misty vision

- Difficulty seeing clearly in low light

- Difficulty seeing when driving at night

- Increased sensitivity to bright lights or glare

- Halos around lights

- Colours appearing faded, less vivid or slightly yellow

- Needing brighter light to read comfortably

- Double vision in some cases

What is the first sign of cataracts?

There's no single first sign that everyone experiences. Early cataracts can be subtle, and some people might not have many noticeable symptoms at first.

You might first notice that your vision isn't as crisp as it used to be, that colours look less vivid or that you're finding it harder to see in low light. Another possible sign is needing changes to your glasses prescription more frequently but still feeling that your vision isn't quite as clear as you'd expect.

If something about your vision doesn't feel right, you don't need to work out the cause yourself. Your optometrist can examine your eyes and talk through what you've noticed.

What causes cataracts?

Age is the most common factor associated with cataracts. As your eyes naturally change over time, the lens can gradually become less clear.

Other factors can increase the likelihood of developing cataracts or may play a role in them developing earlier.

These include:

- Getting older

- Diabetes and some other long-term health conditions

- Long-term use of steroid medication

- Smoking

- Regular exposure to UV light without suitable eye protection

- Previous eye injury or eye surgery

- A family history of cataracts

- Certain other eye conditions

Some people are born with cataracts or develop them during childhood, although this is much less common than age-related cataracts.

Are there different types of cataracts?

There are several types of cataracts, and each is named according to the part of the lens where the clouding develops.

The three main types of cataracts are:

Nuclear cataracts

These develop in the central part of the lens, known as the nucleus. They are commonly associated with ageing and can develop gradually.

Cortical cataracts

These affect the outer part of the lens. They can cause changes in the way light passes through the eye and may cause problems with glare or contrast in your vision.

Posterior subcapsular cataracts

These develop towards the back of the lens. They can affect vision particularly when reading or in bright light.

The type of cataract you have isn't always obvious from your symptoms alone. An optometrist can examine your eyes to identify changes to the lens and explain whether your symptoms might be linked to a certain cataract type.

How are cataracts diagnosed?

Cataracts can often be identified during a routine eye examination.

Your optometrist will talk to you about your vision and any changes you've noticed before carrying out the examinations needed to assess your sight and eye health.

Here’s what to expect if you visit a Bayfields optometrist with concerns about cataract symptoms:

1. We talk about your vision

You'll have time to explain any changes you've noticed and how your symptoms are affecting you day to day.

2. We check your eyesight

Your optometrist will assess how clearly you're seeing and whether your prescription needs changing.

3. We assess your overall eye health

Your optometrist will examine the front structures of your eyes, including the lens, as well as the health of the retina and other structures at the back of your eye.

Additional examinations or imaging may be recommended if your optometrist needs more information.

4. We explain your eye test results

If your optometrist identifies signs of cataracts or anything else that needs further assessment, they'll explain what they've found and advise you on next steps.

Our 45-minute eye appointments give you time to talk through changes in your vision, have your eyes thoroughly examined and understand what your results mean.

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How quickly do cataracts progress?

Cataracts don't progress at exactly the same rate for everyone.

Some people may notice very little change for a long time, while others may find that their vision becomes increasingly affected. The rate can depend on factors such as the type of cataract and individual health circumstances.

Because cataracts can change gradually, regular eye examinations are useful for keeping track of your vision and eye health.

If you've noticed your sight becoming increasingly cloudy, blurry or uncomfortable, there's no need to wait until your next routine appointment. An eye test can help you understand whether cataracts or another change could be affecting your vision.

How are cataracts treated?

The appropriate treatment depends on how much the cataract is affecting your vision and your everyday life.

Managing early cataracts

If a cataract is mild and isn't significantly affecting your daily activities, treatment may not be needed straight away.

Your optometrist can monitor your eyes and help you manage changes to your vision. Updating your glasses prescription or making simple changes like improving lighting for everyday tasks can make daily life more comfortable while the cataract remains mild.

Cataract surgery

If a cataract starts to have a more serious impact on your vision and daily life, cataract surgery might be recommended.

Cataract surgery involves removing the cloudy natural lens and replacing it with an artificial lens. It is generally carried out under local anaesthetic, and many people return home the same day.

We don’t provide cataract surgery at Bayfields. If your optometrist believes you may benefit from surgical treatment, they'll explain the appropriate next steps and referral process.

Can cataracts be treated without surgery?

There are currently no medicines or eye drops proven to remove an established cataract.

In the earlier stages of cataracts, practical changes such as an updated glasses prescription, brighter lighting for tasks and reducing glare may make some everyday activities easier. These approaches don't remove the cataract itself, but they may help you manage its effect on your vision.

When a cataract significantly affects your vision and daily life, surgery is the most common and established treatment used to remove it.

If you're unsure how much your cataracts are affecting your vision, an eye test can help you understand more about your current condition on what to do next.

What happens during cataract surgery?

Cataract surgery is normally carried out by an ophthalmic surgeon rather than an optometrist.

During the procedure, the cloudy natural eye lens is removed and replaced with an artificial lens. The operation is usually performed under local anaesthetic, so you'll likely be awake but shouldn't feel pain from the procedure.

Many people can go home from cataract surgery on the same day.

The exact procedure, lens options and aftercare will be discussed with you by the surgical team before treatment.

What is recovery like after cataract surgery?

Your surgical team will give you specific aftercare instructions following cataract surgery.

Many people notice an improvement in their vision surprisingly quickly after cataract surgery, sometimes even within the first few days, particularly if the cataract was significantly affecting their sight beforehand. As your eye heals, it can continue to settle and adjust over the following weeks.

During the early stages of recovery, it's normal to experience mild symptoms such as redness, watering, a gritty sensation or sensitivity to light. You'll usually be prescribed eye drops and given guidance on caring for your eye while it heals.

Most patients are reviewed around 3 to 5 weeks after surgery to assess the final visual outcome and determine whether an updated glasses prescription is needed. Your surgical team will also advise when it's safe to return to activities such as work and driving.

Recovery varies from person to person, so it's always best to follow the advice given by your surgical team rather than compare your recovery with someone else's.

Can cataracts affect everyday life?

Cataracts can have an impact on the things you do every day, particularly as your vision becomes cloudier or more affected by glare.

You might find that you:

Need brighter lighting to read comfortably
Find night-time driving more difficult
Struggle to recognise faces as easily as you used to
Notice colours aren't as clear or vivid
Find screens or reading more tiring
Feel less confident carrying out familiar activities

You may still be able to manage these changes when a cataract is mild. But if your vision is starting to get in the way of the things you enjoy, it's worth talking to an optometrist.

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Can you drive with cataracts?

Whether you're able to drive with cataracts depends on whether your vision continues to meet the required driving standards.

Cataracts can affect clarity, contrast and your ability to cope with glare, particularly in low-light conditions. If you're noticing that driving at night has become more difficult, or your vision doesn't feel as clear as it used to, it's worth having your eyes checked.

If you're concerned about whether your vision meets the UK requirements for driving, your optometrist can assess your sight and advise you on the next steps.

Can cataracts be prevented?

There's no guaranteed way to prevent cataracts from developing, particularly when they're associated with natural changes as you get older.

However, looking after your overall health and protecting your eyes gives you the best chance of maintaining healthy vision.

Simple steps for keeping your eyes healthy include:

Protect your eyes from UV exposure

Wearing sunglasses with suitable UV protection can help protect your eyes when you're outdoors.

Explore prescription sunglasses

Don't smoke

Along with many other health problems, smoking is associated with an increased risk of developing cataracts. If you smoke, stopping can have benefits for your overall health as well as your eyes.

Look after your general health

Some health conditions, including diabetes, can increase your risk of cataracts. Following the advice you're given for managing any long-term condition is an important part of looking after your wider health.

Eat a balanced diet

A varied, balanced diet provides the nutrients your body needs to support overall health, including healthy eyes.

Read about the best foods and vitamins for eye health

Keep up with regular eye tests

Even if your vision seems fine, regular eye examinations give your optometrist an opportunity to check for changes you may not have noticed yourself.

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When should I see an optometrist about cataracts?

It's always worth arranging an eye test if you've noticed a gradual change in your vision.

When it comes to cataracts, it’s especially important to visit an optometrist if:

- Your vision looks cloudy, misty or blurry

- Colours don't seem as vivid as they used to

- You find bright lights or headlights more uncomfortable

- You're struggling to see clearly at night

- You need to change your glasses prescription more often

- Your vision doesn't seem clear even with the right glasses

- Everyday activities like reading or driving are becoming more difficult

You don't need to be certain that you have cataracts before booking an appointment. If something has changed, your optometrist can help you understand why.

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When should you seek urgent help for changes to your vision?

Cataracts generally develop gradually and aren't usually painful.

If you experience any of the following, don't assume it's cataracts or a longer-term issue:

- A sudden or significant change in your vision

- Severe eye pain

- Sudden flashes

- A sudden increase in floaters

These symptoms can have other causes and may require urgent medical assessment.

If you're experiencing sudden changes or severe symptoms, seek urgent medical advice rather than waiting for a routine eye test.

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Cataracts in children

While they’re much more commonly associated with ageing, children can develop cataracts too.

Because children's vision is still developing, changes to their eyesight should be assessed promptly. If you're concerned about your child's vision, a children's eye test can help check how their sight is developing and whether they need any further support.

Learn more about children's eye tests

Cataract FAQs

What is the first sign of cataracts?

There's no single first sign that applies to everyone. Early cataracts may cause subtle changes such as slightly blurry vision, faded colours, increased glare or difficulty seeing in low light.

You may also notice that changing your glasses prescription doesn't improve your vision as much as expected.

What causes cataracts?

Ageing is the most common factor associated with cataracts. Other risk factors can include diabetes and some other health conditions, long-term steroid use, smoking, UV exposure, previous eye injury or surgery and a family history of cataracts.

How quickly do cataracts get worse?

Cataracts can progress at different rates. Some change slowly over a long period, while others may have a greater effect on vision more quickly.

Regular eye examinations can help monitor changes and give you an opportunity to discuss any concerns about your sight.

Can cataracts be treated without surgery?

There isn't currently a proven medicine or eye drop that removes an established cataract. In the earlier stages of cataract development, an updated prescription, better lighting or reducing glare may make some activities easier.

When a cataract starts to significantly affect vision and daily life, cataract surgery is often the best treatment path.

How do I know if I need cataract surgery?

The decision to have cataract surgery depends on how much the cataract is affecting your vision and everyday life, as well as the assessment and advice of your eye specialist.

If you're concerned about changes to your vision, your first step can be an eye test. Your optometrist can assess your eyes and explain whether further assessment or referral may be appropriate.

How long does it take to recover from cataract surgery?

Recovery varies between people. Your vision may begin to improve relatively quickly, but your eye can take several weeks to fully settle.

Your surgeon will give you specific advice about eye drops, activities, driving, work and follow-up appointments.

Can I drive if I have cataracts?

You can drive only if your vision meets the required driving standards. Cataracts can affect clarity and make glare or night-time driving more difficult.

If you're concerned about your vision when driving, arrange an eye test and check the current DVLA requirements.

Can cataracts come back after surgery?

A cataract itself doesn't grow back once the cloudy natural lens has been removed. However, some people can develop clouding of the capsule behind the artificial lens after surgery, known as posterior capsule opacification (PCO).

Related eye health conditions

Changes such as blurry vision, glare or difficulty seeing clearly aren't always caused by cataracts. There are many different conditions that can affect your vision, which is why an eye examination can be helpful if something has changed.

Learn about eye health conditions

Looking after your eye health

Cataracts are just one of the changes your eyes can experience throughout your life. Regular eye care can help you understand what's happening with your vision and identify changes that may need further attention.

From advanced eye health imaging to advice about your everyday vision, we'll give you time to ask questions and understand what your eyes need.

Learn more about OCT scans

Learn about Optomap® retinal imaging

Find out more about eye care at Bayfields

If you're concerned about cataracts, an eye test is a good place to start. Your optometrist can assess your vision and eye health, explain what they've found and let you know if any further care is needed.

Our 45-minute eye appointments give you time to talk through changes in your vision without feeling rushed.

Book an eye test

Find your nearest Bayfields

More ways to look after your vision

Understanding a change in your vision is just one part of looking after your eyes. Whether you need a new prescription, want to explore different ways of seeing clearly or simply need some extra support, we're here to help.

Find glasses that suit your life

If cataracts or other changes have affected your prescription, the right glasses can help you see comfortably in the situations that matter to you.

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Protect your eyes outdoors

Sunglasses can help protect your eyes from UV exposure while giving you comfortable vision outdoors. Explore prescription and non-prescription options in a range of styles.

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Explore contact lenses

If you’d rather not rely on glasses all the time, contact lenses can offer another way to correct your vision. We'll help you find a solution that's comfortable and suited to your lifestyle.

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Connect brings regular eye and hearing care together in one simple monthly membership, with added benefits and savings to help you stay on top of your health throughout the year.

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