These vary according to the age, lifestyle, visual requirements of the patient, according to the type of cataract and whether the cataract is unilateral or bilateral (1).
Cataracts in older children and adults:
- the chief complaint is gradual loss of vision, although this may occasionally be rapid as in true diabetic cataract - note that macular degeneration also produces a painless reduction in vision and is also common in the elderly
- this may be worse for near or distance - for example it is characteristically worse for distance in nuclear sclerosis even after refractive correction
- other features may include:
- dazzle/glare - this especially may occur when driving at night
- monocular diplopia- light scattered by the cataract may produce multiple images
- frequent spectacle changes
- difficulty in reading
- difficulty recognizing faces
- reduction in colour intensity
- gradual reduction in contrast
- difficulty in driving - at night or daytime (1)
Diagnosis is confirmed via retro-illumination of cataract using a handheld ophthalmoscope.
Reference:
- Allen D, Vasavada A. Cataract and surgery for cataract. BMJ. 2006;333(7559):128-32