How Your Lifestyle May Influence the Type of Cataract You Develop

Our lifestyle choices, daily habits, and how we manage our health have a profound impact on our bodies, and our vision is no exception. Emerging medical research is increasingly highlighting a fascinating link between certain lifestyle factors, systemic health conditions, and the specific types of cataracts we may develop. For example, recent research has indicated that timely cataract surgery is associated with a significantly lower risk of developing dementia over the long term.

This article will help you understand how different lifestyle and health factors may predispose individuals to a particular type of cataract. Additionally, it highlights a crucial fact: no matter the type of cataract, there is only one definitive, clinically proven safe and effective treatment for advanced cataracts, and that is cataract surgery.

Understanding the Main Types of Cataract

For most of us, the word “cataract” brings to mind an image of a cloudy film that obscures sight. But a cataract is not a film on the eye, but rather a clouding within the eye’s natural lens itself. Just as there are different causes, there are also different types of cataract, each with its own unique characteristics.

To understand the different types of cataracts, it helps to think of your eye’s natural lens as the lens of a sophisticated camera. Located just behind the iris, its job is to focus light onto the retina, giving you sharp, clear images.

The lens is mostly made of water and proteins, arranged in a way that keeps it transparent. However, as we age, these proteins can break down and clump together, creating a cloudy area, which marks the beginning of a cataract.

The most common types of cataracts are classified by where this clouding first occurs:

• Nuclear Cataracts: The most common form, this type forms deep in the central part of the lens, known as the nucleus.
• Cortical Cataracts: These begin as wedge-shaped opacities in the outer layer of the lens (the cortex) and slowly work their way inward towards the centre.
• Subcapsular Cataracts: This type of cataract forms at the back of the lens, just under the lens capsule.

Nuclear Cataracts: The Ageing & Smoking Connection

Nuclear cataracts are the most prevalent type and are often a natural consequence of the ageing process. Over time, the lens hardens and yellows, causing vision to become cloudy or dim. This can also cause colours to fade or appear yellowed. While this is a common part of getting older, the process can be significantly accelerated by certain lifestyle choices.

Smoking is one of the most significant and preventable risk factors for nuclear cataracts. The toxins from cigarette smoke can cause oxidative damage to the lens, speeding up the protein breakdown that leads to cataract formation. Studies have consistently shown that smokers have a higher risk of developing cataracts and tend to develop them at a younger age compared to non-smokers. Quitting smoking is one of the best things you can do to protect not only your vision but overall health.

Cortical Cataracts & The Diabetes Link

Cortical cataracts typically begin with white, wedge-shaped opacities in the periphery of the lens, much like spokes on a wheel. These then extend inward toward the centre.

There is a well-established and serious link between diabetes and the development of cortical cataracts. With the high prevalence of diabetes in Singapore, this is a growing concern. High blood sugar levels can cause changes in the water and sugar balance within the eye’s lens, leading to swelling and eventually, clouding. Patients with diabetes often develop cataracts at an earlier age and may see the condition progress more rapidly.

A comprehensive eye exam, which is part of a cataract assessment, is a critical opportunity for early detection of related systemic health indicators like diabetic retinopathy. The dilated eye exam is the primary method for identifying the tell-tale signs of diabetic retinopathy, such as leaking blood vessels or retinal swelling, enabling timely intervention to protect your sight.

Subcapsular Cataracts: The Steroid & Sun Exposure Connection

Subcapsular cataracts are less common but can be particularly problematic because their formation at the back of the lens often interferes with reading vision and night vision more than other types.

Primary factors strongly linked to subcapsular cataract:

• Long-Term Steroid Use: Prolonged use of corticosteroid medications, whether taken orally or in eye drop form, can significantly increase the risk of developing subcapsular cataracts. The mechanism by which corticosteroids contribute to cataract formation is complex and not fully understood, but it is believed to involve several factors. These include alterations in lens fiber cell metabolism, increased oxidative stress within the lens, and disruption of the delicate fluid and electrolyte balance that maintains lens transparency.
• Sun Exposure: The World Health Organization estimates that up to 20% of global cataracts may be caused by overexposure to UV radiation. Unprotected exposure to the sun’s ultraviolet (UV) rays is a known risk factor. Just as UV radiation can damage your skin, it can also harm the proteins in your lens. Wearing UV-protective sunglasses is a simple and effective way to lower this risk.

Modern Cataract Surgery – A Singular Solution 

While managing lifestyle factors can reduce your risk, it’s important to remember that cataracts are a progressive condition. Regardless of the specific type of cataract (e.g., nuclear, cortical, subcapsular) or its underlying cause (e.g., age-related, traumatic, congenital, secondary to medical conditions or medications), the only universally recognised and effective treatment is surgical intervention. This involves the removal of the eye’s natural, clouded lens and its replacement with a new, clear artificial intraocular lens (IOL).

Modern cataract surgery is a brief outpatient procedure with an exceptionally high success rate in restoring vision. This clinically proven safe and efficient procedure allows you to regain a world of vibrant color and sharp detail, letting you get back to a life of clarity.

It is typically a brief outpatient procedure, often completed in less than 30 minutes, allowing patients to return home the same day. The recovery period is generally short, for the majority of patients who reported experiencing improved vision within days, and full recovery within a few weeks.

Navigating Financials & Insurance for Your Procedure

Here at JL Eye Specialists, we believe the journey to better vision should be as stress-free as possible, and that includes being well-informed about the financial aspects of your care. We are committed to helping you understand and manage the costs associated with your cataract procedure. We will help you understand the primary avenues for funding your surgery and care, including:

• MediShield Life: As a Singapore Citizen or Permanent Resident, this national insurance plan provides essential baseline coverage for cataract surgery. Our team can help you understand the claim limits and any potential out-of-pocket expenses.
  
• Integrated Shield Plans (IPs): For more extensive coverage, your private Integrated Shield Plan can be used. We encourage you to check with your insurer about your plan’s specifics, especially regarding pre-authorisation and whether your surgeon is on their approved panel. Our clinic is here to help if you have questions about using your plan at our clinic.
  
• MediSave: You can use funds from your MediSave account to pay for your procedure, subject to Ministry of Health (MOH) limits. Our staff will guide you through the simple paperwork required to utilise your own or an immediate family member’s funds.
  
• Corporate Health Benefits: If you have a corporate health plan through your job, your surgery might be covered. Talk to your HR department or insurer to see what your policy covers.

A Clear-Sighted Future with JL Eye Specialists

At JL Eye Specialists, we view your cataract treatment as a collaborative process where you are the central focus. At the helm is Dr. Jimmy Lim, our Medical Director and Senior Consultant, who brings more than two decades of experience in cataract management, and the diagnosis and treatment of a wide spectrum of eye conditions, including glaucoma and retinal issues.

Our clinic is dedicated to ensuring that your treatment is tailored precisely to your individual needs and lifestyle aspirations. We understand that every patient’s eyes are unique, and we take the time to listen to your concerns, answer your questions, and develop a treatment plan that gives you confidence and ensures the best possible outcome.

If you are noticing changes in your vision or simply believe it is time for a thorough check-up, we invite you to take the next step. Schedule a comprehensive eye examination with us to receive a thorough assessment and discuss a course of action that is right for you. Please contact (65) 6258 8966 or WhatsApp (65) 8163 2807.