Patient's question:
What causes cataracts? Do they pose significant harm to the body? Will they cause blindness? What's the difference between cataracts and glaucoma?Doctor's answer:
Analysis of the condition: It can be classified as congenital or acquired. Congenital cataracts are usually present at birth or shortly after, with a small portion developing gradually after birth. Most are hereditary diseases and are divided into endogenous and exogenous types. Endogenous cataracts are associated with fetal developmental disorders, while exogenous cataracts result from systemic diseases or localized eye conditions, nutritional metabolic abnormalities, toxicity, degeneration, or trauma affecting the lens. Congenital cataracts are further classified into anterior polar cataracts, posterior polar cataracts, nuclear cataracts, and total cataracts. The first two do not require treatment, while the latter two necessitate surgical intervention. Acquired cataracts are caused by systemic diseases, localized eye conditions, nutritional metabolic abnormalities, toxicity, degeneration, or trauma leading to lens opacity. They are divided into six types: ① Senile cataracts. The most common type. They are more prevalent in individuals over 40 and increase with age. The etiology is related to degenerative changes due to slow metabolism in the elderly, though some attribute it to long-term sun exposure, endocrine disorders, or metabolic abnormalities. Based on the initial location of opacity, they can be categorized into nuclear and cortical types. Visual impairment is related to the location and density of opacity, with posterior cortical and nuclear opacities affecting vision earlier. Treatment primarily involves surgery, followed by the use of contact lenses or intraocular lens implantation during the procedure. ② Secondary cataracts (occurring in conjunction with other eye diseases). ③ Traumatic cataracts. ④ Metabolic cataracts (due to endocrine dysfunction, such as diabetic cataracts). ⑤ Radiation cataracts (associated with X-rays, beta rays, gamma rays, etc.). ⑥ Drug-induced and toxic cataracts. If left untreated, the opacity in the lens will progressively worsen, eventually leading to complete blurring, lens nucleus disintegration, and complete loss of vision.Medical advice: The symptoms of glaucoma generally fall into the following categories: The symptoms of angle-closure glaucoma include episodic headaches, severe orbital and ocular pain; the appearance of colored halos around light sources when looking at them (phosphenes); blurred vision, with severe cases only perceiving light or hand movements; nausea, vomiting, and constipation; conjunctival redness, with severe cases causing eyelid edema; elevated intraocular pressure, making the eye feel hard like a stone when touched; corneal opacity with a hazy appearance and loss of luster; and pupil dilation. The symptoms of open-angle glaucoma are usually not noticeable in the early stages. A few patients may experience dizziness, eye pressure, and hazy vision during high-pressure periods. Early intraocular pressure is unstable, with fluctuations occurring only for a few hours within a day. In later stages, intraocular pressure is often consistently elevated; the physiological of the optic disc expands, and visual field defects develop. The symptoms of primary open-angle glaucoma are generally asymptomatic in the early stages. As the disease progresses, mild eye pressure, vision fatigue, and headaches may appear, though vision is usually unaffected. The visual field gradually narrows. In advanced stages, when the visual field becomes tubular, difficulty in movement and nyctalopia may occur. Some late-stage cases may also exhibit blurred vision and phosphenes. Therefore, early diagnosis of primary open-angle glaucoma is crucial, emphasizing the need for related examinations in suspected cases. Secondary glaucoma, in addition to symptoms related to the primary disease, exhibits symptoms similar to those of angle-closure or open-angle glaucoma. Due to the obstruction of aqueous humor caused by the primary disease, the symptoms may resemble either angle-closure or open-angle glaucoma, leading to varying manifestations. The symptoms of congenital glaucoma include photophobia, tearing, eyelid spasms, and macrocornea; if onset occurs after the age of three, it may manifest as progressive myopia in children.