If I have been told I have beginning cataracts, what signs should I look for to know if it is getting worse?

Cataract development is almost always quite slow and gradual. Typically one eye will get worse sooner than the fellow eye. Most people do not notice any sort of sudden change in their vision (although that is not impossible). The very earliest symptom of cataract formation is usually Presbyopia, the age-related decline in near vision due to the gradual hardening of the natural lens of the eye. As people get even older and often become dependent on reading glasses, the natural lens starts to discolor, causing a gradual decrease in contrast sensitivity, and increasing difficulty with night tasks like driving. At a certain point, visual acuity starts to become affected, meaning you may no longer be able to read letters on the eye chart. This starts with the very small letters and is no longer correctable with glasses as it may once have been.

Like age-related hearing loss, the decline in visual function is so slow that we often do not recognize it is happening. Lens implant surgery to fix this situation is generally considered once the gradual decrease in vision starts to create difficulties or curtailment of once easily performed visual tasks.

_Written by J. Trevor Woodhams, M.D. - Chief of Surgery, Woodhams Eye Clinic