It is said that age is just a number. This is true in many ways. However, the human body is constantly ageing and changing. Our eyes also undergo such changes, the commonest being the development of cataracts. In simple terms, a cataract is the clouding of the natural, clear lens in the eye. This leads to gradual blurred and hazy vision, loss of contrast sensitivity, glare, haloes and dimness of colour vision. These changes happen naturally in old age. But lately, people are being diagnosed with cataracts at a significantly earlier age than in previous generations. This leads us to the question: Why are more Indians being diagnosed with cataracts before the age of 60?
One of the most common reasons for the early onset of cataract in Indians is 'Diabetes Mellitus'. India is referred to as the ‘Diabetes capital of the world’. High blood sugars damage the proteins in the lens, causing clouding of the clear lens. Therefore, cataract develops faster in uncontrolled diabetics. It also tends to be more complicated.
Uncontrolled diabetes can also lead to diabetic retinopathy, which may cause permanent damage to the retina and loss of vision. For this reason, strict blood sugar control is of utmost importance. Regular blood sugar monitoring, dietary control, exercise, lifestyle modifications and frequent visits to a diabetologist are crucial in managing diabetes.
Another reason for developing cataract at a significantly earlier age is the use of steroids. Steroids in the form of eye drops, skin creams, inhalers or oral tablets are often misused by patients. Some medicines taken locally may even contain hidden steroids. Chronic and indiscriminate use of these medicines leads to the development of a type of cataract called posterior subcapsular cataract, which may drastically affect vision. Long-term use can also cause steroid-induced glaucoma. People should be made aware of the side effects of steroids and only take them if prescribed by a well-qualified doctor. They should also undergo regular eye check-ups by an ophthalmologist.
Environmental factors, such as increased exposure to UV radiation, smoke, air pollution and particulate chemicals, may accelerate cataract formation due to oxidative stress on the lens proteins. Due to global warming and worsening air pollution over the years, these factors have become more significant in the development of cataract. Wearing UV protective sunglasses, hats and caps is a must to avoid sun damage to the eyes. Appropriate use of masks is necessary to avoid the harmful effects of smoke, chemicals and polluted air.
Other lifestyle factors that contribute to early cataract formation include smoking, alcohol, eating highly processed foods with poor antioxidant content and conditions like obesity and metabolic syndrome. These need to be addressed appropriately. Foods rich in antioxidants, such as fruits, nuts, green leafy vegetables, etc., should be consumed to reduce the effects of oxidative stress. Smoking and alcohol usage should be avoided or minimised. Genetic predisposition or developmental changes can also be a cause of early-onset cataract.
Besides these factors, earlier cataract detection is also attributed to better awareness amongst people, leading to more frequent eye check-ups. Advanced equipment available in most places can detect cataracts in the very early stages. Previously, people used to visit ophthalmologists only when their vision and daily activities were severely impaired, leading to a much later age of detection. But nowadays, most people get their eyes checked even for minor vision fluctuations, therefore being diagnosed with cataracts at a much younger age.
The author is consultant cornea, cataract and refractive surgeon at Dr Agarwals Eye Hospital, Mumbai.
The opinions expressed in this article are those of the author and do not purport to reflect the opinions or views of THE WEEK.
