Eye anatomy.
  • Opacification of the lens of one or both eyes, which can lead to decreased visual acuity and visual distortions
  • Most commonly due to normal age related changes, however they can also be caused by eye trauma, exposure to sunlight or radiation, malnutrition, corticosteroid use, and other pathologic processes
  • By age 80, approximately 50% of Americans have been diagnosed with one or more cataracts[1]
  • Additional risk factors for cataract include diabetes, smoking, prolonged exposure to sunlight, and alcohol use[2][3]
  • Typically a non-emergent pathology and can be managed with outpatient ophthalmologic surgery on a routine basis.
    • With the exception of traumatic cataract, vision loss from cataract is typically not acute; rather, develops over the course of months to years.

Clinical Features

The appearance of a dense, white cataract in a 60 year-old male.
  • Vision loss typically not acute but develops over months to years (unless traumatic cataract)


  • Cloudy or blurry vision
  • Difficulty with night time vision
  • Colors appear faded
  • Appearance of a halo around bright lights
  • +/- Recent trauma to the eye

Exam Findings

  • Lens opacity
  • Darkening of red reflex
  • Decreased visual acuity

Differential Diagnosis

Acute Vision Loss (Noninflamed)

Emergent Diagnosis

Subacute Vision Loss (Noninflamed)

  • Cataracts
  • Congenital blindness
  • Diabetic retinopathy

Orbital trauma



Unilateral red eye

^Emergent diagnoses ^^Critical diagnoses


  • Typically diagnosed clinically by the finding of lens opacity on direct ophthalmic exam
    • Precise classification (nuclear, cortical, posterior sub-capsular) may be done by ophthalmologist
  • If the patient has risk factors for diabetes or HIV/AIDS, consider appropriate diagnostic tests


  • Definitive treatment is (typically outpatient, non-emergent) surgery, wherein clouded lens is removed and replaced with clear, artificial lens
  • Other supportive care modalities that help with visual symptoms include:[4]
  • Using brighter lights while at work or at home
  • A trial of anti-glare sunglasses for outdoor activities
  • Using magnifying lens glasses for reading and other daily


  • Discharge with optho follow up

See Also

External Links


  1. National Eye Institute, "Cataracts" <>, accessed 16 Dec 2020
  2. National Eye Institute, "Cataracts" <>, accessed 16 Dec 2020
  3. West SK, and Valmadrid CT, "Epidemiology of risk factors for age-related cataract," Surv Ophthalmol. 1995;39(4):323.
  4. National Eye Institute, "Cataracts" <>, accessed 16 Dec 2020