Age-related cataract is the gradual clouding of the eye’s natural crystalline lens with advancing age. It is the single most common cause of reversible visual impairment worldwide. At Suraj Eye Institute, cataract surgery is one of the most frequent procedures we perform, and modern techniques allow rapid visual recovery with excellent outcomes.

The Three Patterns of Age-Related Cataract

1. Nuclear Sclerotic Cataract

The central core (nucleus) of the lens hardens and yellows with age. This is the commonest pattern. Early nuclear sclerosis causes a myopic shift — patients paradoxically find they can read without glasses (“second sight”), but distance vision deteriorates. Over time, colours appear dull or yellowed, and night vision suffers.

2. Cortical Cataract

Wedge-shaped, spoke-like opacities develop in the outer cortex of the lens, extending from the periphery inward. Patients complain of glare — particularly from oncoming headlights at night and from sunlight. Diabetics and those with high UV exposure develop cortical changes earlier.

3. Posterior Subcapsular Cataract (PSC)

A plaque-like opacity just in front of the posterior capsule, central in the visual axis. Even small PSC causes disproportionate symptoms — difficulty reading, marked glare in bright light, and poor vision against a bright background. Common in diabetics, long-term steroid users, and younger patients. Explored in detail on our PSC page.

Risk Factors

• Age — the single strongest risk factor
• Diabetes mellitus — earlier onset and faster progression
• Ultraviolet light exposure — cumulative effect over decades
• Smoking — strongly linked to nuclear cataract
• High myopia — nuclear sclerosis tends to progress earlier
• Systemic steroids — posterior subcapsular opacities
• Previous eye trauma, uveitis or retinal surgery
• Family history — not strongly hereditary but some familial trend

Symptoms to Watch For

• Gradual, painless blurring of vision
• Difficulty driving at night — glare from headlights
• “Yellow film” effect — colours appear less vivid
• Reduced contrast sensitivity — faces harder to recognise in low light
• Frequent changes of spectacle prescription
• Monocular double vision (two images seen with one eye closed)
• Reading becomes harder even with glasses

How Age-Related Cataract Is Diagnosed

Diagnosis is straightforward with a slit-lamp examination after dilatation of the pupil. At Suraj Eye Institute, your consultation also includes:

• Best-corrected visual acuity for distance and near
• Refraction to confirm that the problem is not just a glasses change
• Intraocular pressure measurement and angle assessment
• Dilated fundus examination
• Anterion biometry for IOL power calculation
• Macular OCT where a retinal cause of poor vision must be excluded

See our consultation and decision page for more on how we decide together whether surgery is right for you.

Treatment — Surgery Is the Only Definitive Option

No drops, diet, or supplement reverses lens opacity. In the early stages, updating your glasses prescription and using good lighting for reading may be enough. When the cataract starts affecting your daily life, modern phacoemulsification offers a quick, safe and highly effective solution. For very dense or white cataracts, manual small-incision cataract surgery (MSICS) may be preferred.