What are Nuclear Cataracts?
A nuclear cataract, also called a nuclear sclerotic cataract, is the clouding and hardening of the central part of the eye’s lens. Nuclear cataracts progress slowly over time and are age-related. They can develop in one or both eyes.
Vision decreases as the cloudy lens hardens and turns a yellowish color. People typically experience trouble with reading and colors becoming less vivid.
With nuclear cataracts, people often experience a temporary vision improvement before it slowly worsens. This phenomenon is called second sight.
Cataracts are treated easily with surgery. However, if left untreated, they can lead to blindness.
Other Types of Cataracts
Nuclear cataracts are the most common type of cataract. Other types of cataracts include:
- Traumatic cataracts. Caused by an eye injury.
- Radiation cataracts. Caused by UV light from the sun and radiation from cancer treatments.
- Congenital cataracts. Present at birth and may be hereditary.
- Secondary cataracts. Caused by scar tissue after surgery.
What Causes Nuclear Cataracts?
The breakdown of eye proteins as you get older causes nuclear cataracts, usually after age 40.3
As proteins break down and clump together, the nucleus (center) of the lens turns cloudy, making it difficult for light to pass through, leading to blurred vision.
While nuclear cataracts are typically associated with aging, other risk factors include:
- Chronic health problems
- Increased exposure to ultraviolet light
- Eye injury
- Excessive smoking
- Drinking too much alcohol
- Prolonged use of steroids
What are the Symptoms of Nuclear Cataracts?
Since a nuclear cataract progresses over time, signs and symptoms develop slowly. Symptoms and vision problems might not be obvious for years.
Common nuclear cataract symptoms include:
- Blurred or cloudy vision
- Trouble distinguishing colors
- Sensitive to bright lights
- Halos around lights
- Double vision
- Blurred vision during driving
- Frequent eyeglass or contact prescription changes
- Cloud or yellowish hue on the lens
Talk with your doctor if you’re experiencing symptoms of cataracts. These symptoms can also be a signal of other eye conditions.
How are Nuclear Cataracts Diagnosed?
Nuclear cataracts are diagnosed during a comprehensive eye exam by a licensed ophthalmologist. Your pupils will also be dilated (widened) so the doctor can look at the structures behind your eye.
Specific tests can help eye doctors detect cataracts. These tests include:
- Slit-lamp exam. A microscope used to spot cornea, lens, and iris abnormalities.
- Retinal exam. An examination of the retina (transparent layer at the back of the eye) that checks for signs of a cataract.
- Visual acuity test. A test that assesses the clarity and sharpness of your distance vision.
When cataracts are discovered during an eye exam, your eye doctor will explain your treatment options, including surgical and nonsurgical interventions.
Treatment for Nuclear Cataracts
Your eye doctor develops a treatment plan for a nuclear cataract. The team may also include other members of your health care team (primary care doctor, for example).
The plan may include surgical and home treatments, depending on the severity of changes to vision and quality of life.
Cataracts can only be removed surgically, but home treatments may help slow vision decline.
Nonsurgical treatments may include:
- Installing brighter lights around the house
- Wearing anti-glare sunglasses
- Using a magnifying lens for reading smaller text
- Wearing protective eyewear to prevent injuries
- Getting a new prescription for eyeglasses or contact lenses
- Limiting driving at night
Cataract surgery is the only way to remove a nuclear cataract and is one of the safest and most effective procedures in the United States.3
Your doctor will recommend surgery when the nuclear cataract affects vision and the quality of life.
Cataract surgery involves replacing your cloudy lens with a new artificial lens (intraocular lens). 9 out of 10 people can see better after cataract surgery.
Hazy vision may return years after having cataract surgery. This occurs when the capsule holding the artificial lens in place becomes cloudy. An ophthalmologist can restore vision using a laser procedure called a capsulotomy.
Can You Slow the Progression of Nuclear Cataracts?
While a nuclear cataract can’t be reversed or removed without surgery, you can take steps to slow the progression of vision decline, including:
- Get a routine dilated comprehensive eye exam once a year
- Protect your eyes from sunlight and injury by wearing sunglasses
- Quit smoking
- Take care of chronic health conditions
- Control your blood sugar if you have diabetes
- Eat plenty of healthy foods (fruits and vegetables)
- Reduce alcohol use
A nuclear cataract is a standard part of the aging process. It develops in the eye's nucleus (center), leading to a hardening, cloudy lens. A nuclear cataract slowly progresses over time, leading to vision changes.
Cataract surgery is the only way to remove a nuclear cataract. Nuclear cataracts typically develop after age 40 when eye proteins start to break down and clump together. Both surgical and non-surgical treatment options are available depending on the severity of vision changes.
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