Nuclear Cataracts: Symptoms, Causes & Treatment

Nuclear cataracts are the most common kind of cataract, characterized by a clumping of proteins in the eye’s nucleus. They form in the center, or nucleus, of the eye’s lens and cloud vision.

This is usually due to these proteins breaking down as a result of aging. Notable clumping of these proteins generally occurs around age 40, forming small clouds and worsening as you get older. 

Nuclear cataracts can be treated with surgery, usually resulting in a level of vision comparable to what you had before cataracts (assuming you haven’t also developed unrelated eye conditions).

Symptoms of Nuclear Cataracts

Cataracts affect your vision, occurring in one or both eyes, usually characterized by a blurring effect that some people describe as like looking through a dirty window. The symptoms of cataracts are normally the same, whether it is a nuclear cataract or occurs on a different area of the lens.

Common symptoms of nuclear cataracts include the following:

• Blurred vision
• Fading or filtered colors when looking at objects
• Glares or halos when looking at lights
• Poor night vision or dimming vision
• Double vision
• Frequent changes in eyewear prescriptions 

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Types of Cataracts

There are several types of cataracts, and technically, any type could be a nuclear cataract if it occurs on the eye’s nucleus. Most nuclear cataracts are the result of aging.

Age-Related Cataracts

This is the most common type of cataract. It occurs due to the natural aging process.

Traumatic Cataracts

These cataracts form as the result of eye injury.

Radiation Cataracts

These cataracts can form if the eye is exposed to radiation, notably from the sun’s ultraviolet (UV) rays and some cancer treatments.

Pediatric Cataracts

Some children develop cataracts as the result of genetics or birth complications. This broad category can also include cataracts that also fall into another cataract type. For example, a child who experiences a traumatic eye injury can also develop a cataract that is both traumatic and pediatric since, by definition, it was caused by trauma and experienced by a child.

Secondary Cataracts or Posterior Capsule Opacification

While these are often called cataracts, posterior capsule opacification is actually a different phenomenon that just has a similar impact on the patient’s vision. 

After cataract surgery, many patients develop cloudy vision as scarred tissue forms over the lens inserted during their surgery. However, this is easily fixed with a laser treatment. 

Causes of Nuclear Cataracts

The word nuclear in nuclear cataract is meant in the anatomical sense, referring to the nucleus of the eye. Your eye’s nucleus is deep within its center and a core part of how the eye sees. 

A cataract is a clouding of the eye, which makes it more difficult for light to pass through. It is not unlike looking through a dirty window. 

This effect is usually the result of aging, which can cause key proteins in the eye to break down and distort the once-clear parts of the eye enough that sight is noticeably affected. This usually begins as small, cloudy spots that can grow over time, causing vision to blur or dim further.

Risk Factors for Nuclear Cataracts

While simple aging is the primary risk factor for nuclear cataracts, the following are additional risk factors:

• Drinking excessive amounts of alcohol
• Smoking
• Using steroids for long periods
• Certain eye surgeries, including glaucoma surgery
• Diabetes
• A family history of cataracts

Diagnosis 

Checking for cataracts is usually a simple process. Your doctor will examine you as part of a dilated eye exam, which is a fast and generally painless process. 

These exams can make your eyes temporarily sensitive to light and can blur your vision for a few hours. You will need someone to drive you home after the exam. Bring sunglasses to wear after, even if the day doesn’t seem very bright. They can block out some incoming light as the effect of the drops wears off.

Treatment for Nuclear Cataracts

The only way to treat cataracts is via surgery to remove them. 

Generally, a doctor will work with a patient to develop the best plan for their current circumstances. Surgery is usually delayed until a cataract has enough of a negative impact on life that other more temporary treatments no longer work well enough.

These more temporary treatments include using brighter lights to offset any dimming effect caused by the cataract and wearing corrective eyewear, such as glasses. 

Surgery involves a surgeon first removing your eye’s natural lens, which is clouded by the cataract. Then, a synthetic lens, called an intraocular lens (IOL), is inserted in its place. This lens can’t adjust to light conditions like your natural lens can, so you may need corrective eyewear like reading glasses after the surgery. 

Cataract surgery is a safe and effective procedure that usually helps a person return to their level of visual acuity before they had a cataract. 

The synthetic lens won’t develop true cataracts because it is synthetic, so cataracts cannot recur. It is possible to develop posterior capsule opacification, as described above.

Monitoring the Progression of Nuclear Cataracts

Because most cataracts are the result of aging, there isn’t much a person can do to prevent their development.

Some evidence suggests that stopping or avoiding smoking can slow the growth of cataracts, but even a person practicing good habits can develop them too. For the most part, the best way to approach your cataract risk is to look at the risk factors noted above, control those that you can, and talk to your doctor about those outside your control. 

Regular eye exams can ensure that any developing cataracts are diagnosed early. Your doctor will then monitor its progression and may prescribe corrective eyewear. When it grows to the point that your vision is obscured, they may recommend cataract removal surgery.

Nuclear Cataracts FAQs

What causes nuclear cataracts?

Aging is the most common cause of nuclear cataracts. They may also be influenced by excessive UV exposure and lifestyle habits like smoking and excessive drinking.

Is a nuclear cataract the same as an age-related cataract?

A nuclear cataract might be called a “standard” cataract diagnosis. When many people discuss a “cataract,” they mean “age-related nuclear cataract.” 

Is a nuclear cataract serious?

This is a common vision condition among people over 40. Cataracts are not life-threatening. They will worsen over time and reduce a person’s vision in the affected eye, but they can be removed via surgery.

Cataracts cannot spread from one eye to the other, although some people do develop cataracts in both their eyes.

Is cataract surgery safe?

While all surgery carries risk, severe complications are rare. Most people achieve a level of vision after surgery that is equal to what they had before cataract development. It is widely considered a safe and effective surgery. 

How do you identify a nuclear cataract?

A nuclear cataract is characterized by clouding in the nucleus of the eye. A doctor will use dilating drops and special noninvasive tools to look into your eye to identify signs of a cataract and other eye conditions. You may notice symptoms of a nuclear cataract, such as blurriness or clouding in your vision, but a professional needs to diagnose it.

References

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   Nuclear Cataract. National Library of Medicine.

2. Cataract. (May 2018). MedlinePlus.

3. Cataracts. (April 2022). National Eye Institute. 

4. Nuclear Cataract. (March 2015). Kellogg Eye Center.

5. Types of Cataract. (August 2019). National Eye Institute.

6. Radiation Cataract. (October 2012). Annals of the ICRP.

7. Restoring Sight: How Cataract Surgery Improves the Lives of Older Adults. (June 2008). Community Eye Health Journal.

8. Risk Factors for Nuclear and Cortical Cataracts: A Hospital Based Study. (July–September 2015). Journal of Ophthalmic & Vision Research. 

9. Nuclear Cataract Shows Significant Familial Aggregation in an Older Population after Adjustment for Possible Shared Environmental Factors. (July 2004). Investigative Ophthalmology & Visual Science.

10. Clinical Grading of Nuclear Sclerotic Cataracts. Clinical & Refractive Ophthalmology.