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Nuclear Cataracts

Nuclear cataracts begin at the center of the lens, its ‘nucleus,' and spread out. In a sense, they and cortical cataracts are opposites, starting and progressing in different directions. This is the most common type of cataract in older people and typically limits visibility at distances, making a person nearsighted.

There are known and unknown risks for developing nuclear cataracts. At the top of the list: Smokers have a three-fold increased risk for this type of cataract. In 2005 British doctors reviewed twenty-seven studies of smoking and cataracts. Smoking specifically raised the risk for nuclear cataracts versus the other types. The longer and overall extent to which a person smoked, the greater was their risk for nuclear cataract, up to three-fold (300%) higher for heaviest smokers. This is a ‘dose-response' effect that doctors consider significant. Encouragingly, there were "signs of reversibility" in risks, in that former smokers had lower rates than active ones. In short, it's always beneficial to quit!

Even without smoking, nuclear cataracts will develop in many of those over 50 years old, and occur increasingly with age. This is a slow progressing type of cataract, taking years to develop and giving the lens a faint yellow tint.

Initial symptoms are often hazy vision at distances and increased overall glare from lights. As mentioned, nuclear cataracts are often accompanied by progressive nearsightedness. Farsighted individuals, therefore, may experience some small improvements in their vision, though the cataract itself will continue to spread out and ultimately erase those gains. Near- or farsighted, some changes in eyeglass prescriptions can help counteract early changes occurring in nuclear cataracts, but only to a modest point as the condition progresses. Avoiding glare and using pupil-dilating eye drops can also help for a while.

When the degree of cataract development seriously impacts a person's daily activities and there is no more to gain with the approaches already mentioned, surgery becomes inevitable. Cataract surgery is the most common operation in the US today. In a relatively short operation, an eye surgeon will remove the clouded lenses and replace them with synthetic intra-ocular lenses (IOLs). Standard IOLs are covered by virtually all insurance policies, but may leave the person still needing glasses or contact lenses. Advanced IOL's can be shaped to correct for near- or far-sightedness and may remove the need to corrective lenses. The patient must of course be very careful to protect their eyes for the one to two week recovery period, after which they should be seeing the world more clearly than they have for some time.

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