The Risk Factors of Cataract Formation
You may have heard it said that cataracts are an inevitable part of ageing. But does cataract surgery also have to be an inevitable part of getting older? Not all cataract risk factors are avoidable, but there are some steps you can take to reduce your risk of needing early cataract surgery. Find out about the risk factors of cataract here.
Risk Factors of Cataract
There are a number of cataract risk factors that are currently known. Having one or more of these risk factors of cataract could increase your likelihood of requiring cataract surgery. However, it’s also possible to possess none of these cataract risk factors and still end up needing early cataract surgery. Conversely, all of these factors could apply to you and yet you still continue quite happily with your natural vision. Here are just some of the cataract risk factors we know about.
Older age.
The most common type of cataract is senile or age-related cataracts. Increasing age is the most significant contributing factor to the development of cataracts, making cataract surgery the world’s most commonly performed eye procedure. Experts believe the underlying cause of age as one of the cataract risk factors arises from an accumulation of metabolic by-products, such as damaging reactive oxygen species. These unstable molecules are toxic to many components of the human body. In the eye, they can cause oxidative stress on the fibres of the lens. This causes the lens fibres to lose their optically transparent arrangement and become cloudy, resulting in cataract. Older bodies also tend to be more prone to other health conditions, which could contribute to the formation of cataracts.
Genetics.
Studies have observed familial patterns of cataract development requiring early cataract surgery, indicating there may be an inherited genetic predisposition in cataract formation. However, as of yet, experts don’t fully understand the details of this.
Other types of cataract are those present at birth or shortly after, and those associated with a syndrome or more complex eye condition. The genetics of these forms of cataract are better understood. Around half of the congenital cataracts (those that develop within the first year of life) are thought to be inherited. Cataracts can also be part of other diseases, such as retinitis pigmentosa or neurofibromatosis, which can have genetic influences.
Smoking.
Tobacco smoking is also one of the better-known cataract risk factors (in addition to being a risk factor for various other eye diseases, such as macular degeneration). The toxic compounds contained in tobacco smoke are thought to induce oxidative damage to the eye’s lens, resulting in accelerated cataract development. Similarly, smoking marijuana has been found to be significantly associated with a cataract diagnosis.
High blood pressure.
Elevated blood pressure, medically known as hypertension, can cause various complications. Research has found that one of these is an increased risk of cataracts. This risk of cataract development appears positively correlated to blood pressure, meaning the more severe hypertension, the higher the likelihood of developing cataracts. While it’s not fully understood, a few proposed explanations exist. One is that hypertension causes inflammation throughout the body, which could stress the crystalline lens, inducing cataract formation. Other studies have found that the use of antihypertensive medications may be responsible for the increased risk of cataracts or that specific genes could be involved in both hypertension and cataracts.
Diabetes mellitus.
Diabetes is a systemic metabolic disease involving elevated glucose levels in the bloodstream. This occurs because the pancreas cannot produce a hormone called insulin, which is responsible for signalling the body’s cells to take in glucose from the bloodstream after it’s digested and absorbed from food. High blood glucose levels can damage various organs of the body. In the eye, alterations to fluid retention from high blood glucose concentrations can induce what’s known as a “sugar cataract”. In addition to increasing your risk of developing cataracts, having diabetes can also increase your risk of complications during cataract surgery.
Obesity.
The presence of obesity may influence the risk of needing cataract surgery at an earlier age. Fat cells in excess adipose tissue can release a hormone called leptin. The function of leptin is mainly to regulate appetite and energy balance. However, studies have found that it may also induce oxidative damage to the eye’s lens, resulting in a cataract.
Eye trauma.
Cataracts may be formed through trauma to the eye. This trauma can be blunt (such as from a cricket ball hitting the eye) or penetrating (such as a shard of glass piercing the eyeball). Other forms of trauma include those from inflammatory eye diseases, electrocution, or even certain types of eye surgery. Any disruption or injury to the lens fibres can potentially cause a loss of transparency to this structure, which we then term a traumatic cataract.
Some of these risk factors are modifiable, while others aren’t. Changing your genetics or preventing yourself from getting older is impossible. However, not smoking and wearing appropriate eye protection can reduce your risk of cataracts. Managing any systemic diseases associated with cataracts, such as diabetes, obesity, and hypertension may also help you avoid early cataract surgery.
Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
References
Age-Related or Senile Cataract: Pathology, Mechanism, and Management.
https://austinpublishinggroup.com/clinical-ophthalmology/fulltext/ajco-v3-id1067.php
Genetic Origins of Cataract.
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/817183
Hypertension and Risk of Cataract: A Meta-analysis.
https://www.researchgate.net/publication/269188028_Hypertension_and_Risk_of_Cataract_A_Meta-Analysis
Cataracts.
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts
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