Cataract Prevention

The best way to delay the growth of a cataract is to live a healthy lifestyle. As is the case with many diseases, cataracts are exacerbated or worsened by certain modifiable environmental factors, activities and medical conditions. Following is a list of “modifiable risk factors.” Modifiable risk factors are those factors we can control to some degree. Therefore, by limiting or stopping them, we may possibly slow cataract progression.

Modifiable Risk Factors for the Prevention of Cataracts

Tobacco Use

The effect of smoking is likely to be cumulative; so, the sooner you stop, the better off you will be. If you are a smoker and would like to stop, ask your primary medical doctor. There are medications and smoking cessation programs that may help you achieve this goal.

Alcohol Intake

For a variety of reasons, alcohol intake should be moderated. Although studies show mixed results with regard to the effect of alcohol intake on cataracts, high levels are associated with many other health risks. Therefore, overuse should be avoided.

Protection from exposure to ultraviolet light

Protection from ultraviolet light is very important in cataract prevention. You should wear glasses or sunglasses with full UVA/UVB protection, as well as wide-brimmed hats, whenever possible if you are in a situation that exposes you to UV light. Not only has UV light been linked to cataract progression, but it is also a risk factor for macular degeneration, as well as skin cancer and cancers of the ocular surface (the conjunctiva and cornea). So, protecting your eyes from UV light not only retards cataract progression, but also has the added benefit of possibly preventing irreversible vision loss from macular degeneration. Additionally, it can help prevent cancer of the skin surrounding the eye, and various ocular surface cancers and tissue degenerations, all of which can lead to decreased vision.

Diet Control

There are several mechanisms through which diet can affect your cataract. The first relates to diabetes mellitus. Both Type I (insulin-dependent) and Type II (adult onset, non-insulin dependent) diabetes are well-known risk factors for early cataract progression due to factors related to sugar metabolism. Strict control of both insulin-dependent and non-insulin dependent diabetes leads to improved sugar metabolism. This helps prevent cataract formation and progression. We know that non-insulin-dependent diabetes, which typically begins in adulthood, can result from poor diet, and can sometimes be controlled with diet. Therefore, by maintaining a healthy diet and preventing the onset of diabetes, we can directly and indirectly delay cataract formation.

In addition, there are multiple conditions that affect the retina due to uncontrolled diabetes. Some of these conditions can be treated with lasers, but retinal lasers can lead to cataract progression due to the fact that the laser light passes through the lens before it reaches the retina. Therefore, improved diet and blood sugar control leading to improved control of diabetes, has the added benefit of decreasing the need for retinal laser treatment and a lower risk of secondary cataract progression.

The second mechanism through which diet can affect cataracts relates to obesity. Although many studies have shown a link between obesity and cataract formation, the mechanism by which this occurs is still unclear. Regardless of the mechanism, controlling your weight is an independent step one can take to prevent cataracts. This could also help prevent other medical problems associated with obesity.

Medications

This is a category over which we may have little control. If you have a disease that requires long-term control of inflammation, you may need to use steroids with some regularity. It is important to work with your physician to minimize steroid use as best you can, while still maintaining adequate control of your disease.

Preventable Trauma

The best way to avoid cataracts caused by various forms of trauma is to use the appropriate eye protection for the activity you are performing. For example, if you are hammering a nail, use protective eyewear designed to prevent blunt and penetrating trauma. If you are using potentially harmful chemicals, use protective eyewear designed to prevent chemical injuries. Make sure you use protective equipment specifically designed for the activity you are performing.

In addition, certain types of sporting activities are associated with an increased risk of eye injury. The National Eye Institute, www.nei.nih.gov/sports/findingprotection.asp, and Prevent Blindness America, www.preventblindness.org/preventing-eye-injuries, both provide comprehensive lists of appropriate protective eyewear for specific sports, as well as information on eye injury prevention.

Antioxidants and Their Effect on Aging and Cataracts

There is now evidence that a well-balanced diet, high in antioxidant-rich foods, may lead to delayed cataract progression. Molecules known as free radicals are linked to aging, which includes cataract progression. These molecules are formed as a result of normal body metabolism. They are also produced by poor diet, ultraviolet radiation, smoking, and pollution, among other things. The cumulative effect of free radicals within the body is called oxidative stress. Free radicals have an unpaired electron that can cause damage to the DNA, fats and proteins in normal cells. A free radical will continue to cause a cascade of damage to healthy tissue until it is neutralized. This is accomplished when an antioxidant combines with a free radical, thereby neutralizing it and rendering it harmless. A diet high in antioxidants allows your body to neutralize free radicals more quickly and efficiently, thereby limiting damage to healthy cells and the consequent “aging” that occurs.

The data on antioxidant supplements is mixed. Some studies show favorable results, while others do not with regard to cataract prevention. More research is needed in this area to determine the effect of specific antioxidant supplements and regimens on the prevention of aging, particularly as they relate to cataract prevention and progression. Therefore, at this time, it is preferable to get your antioxidants from a well-balanced diet that includes a wide variety of different antioxidant rich foods. There are many excellent dietary resources available to us today. The American Diabetes Association, www.diabetes.org, and the American Heart Association, www.heart.org, both have extensive dietary and nutritional information that is available to the public free of charge.