Why are patients in their 40s and 50s losing vision for cataracts?
Diabetes is one of the major risk factors that can result in the development of the disea
Arthritis, dementia, osteoporosis: some of the diseases we tend to associate with aging and conditions that most of us would not have to worry about until the third age ... Traditionally, cataracts fit into this category as well.
But leading British ophthalmologists are reporting a worrying rise in the number of cataract cases among people in the 40s and 50s - 20 years or more ahead of expected. It is estimated that about 2.5 million people aged 65 and over in England and Wales have some type of visual impairment caused by cataracts.
But while the median age of patients undergoing cataract surgery (where an artificial intraocular lens is used to replace the disease) is still 76, ophthalmologists are reporting evidence of patients developing the disease much earlier in life.
More people in their 40s and 50s are undergoing cataract surgeries than in the past. These are younger people, who start having trouble driving at night, who are bothered by the bright traffic lights, which begin to see halos around the street lamps. "These are classic early symptoms of cataracts. And although the patient usually does not need an operation right away, he will do it in about five years, when the condition is progressive, "says ophthalmologist Virgílio Centurion, director of the IMO Institute of Ocular Diseases, a retina specialist.
A 2015 audit of Optegra Eye Health Care, which performs ophthalmic surgeries privately, found that one-fifth of cataract surgeries in the UK were people in their 40s and 50s. What is causing this age-related condition to happen much earlier?
One theory is that Britain's type 2 diabetes epidemic may be partly to blame, putting at risk the view of millions of Britons with the disease. Diabetes is already associated with a high risk of blindness. But this is usually in the context of the type 1 version, which affects about 400,000 people in the UK.
"These patients may develop a condition of blindness called retinopathy, in which the retina in the back of the eye is impaired by the effects of the disease on the circulation," explains Virgilio Centurion. But the numbers that could be affected by cataracts are much higher, as rates of type 2 diabetes have doubled over the past 20 years, due in large part to the rise in obesity.
In the UK, one person in ten over the age of 40 - a total of 4.7 million in total - has the disease.
A 2014 study, conducted by scientists at Capital Medical University in Beijing, gathered data from eight studies involving more than 20,000 patients on type 2 diabetes and the risk of cataracts to try to reach a conclusion about these risks. The risk of cataract was found to be up to 68% higher in patients with type 2 diabetes compared to volunteers without the condition
Diabetes may not be the only modern risk factor that increases cataract rates - sunlight can also be a hazard. Scientists at Case Western Reserve University in Cleveland, Ohio, published a study in 2014 showing that the sun's UVA rays triggered a noxious reaction in the lenses of the eye, known as glycation of the proteins, leading to cloud cover.
Some professionals, such as airline pilots, suffer disproportionately from cataracts due to chronic exposure to UV rays. And a 2016 study, conducted by the Boxer Wachler Vision Institute in Beverly Hills, Calif., Found that owners of left-traction vehicles had a higher risk of cataracts in the left eye than in the right eye. The reason? The windshields on most cars are impregnated with a chemical that protects against UVA exposure, but the side windows are often not.
More recently, specialists at the University of Minnesota studied about 45,000 in-house workers and found that those exposed to the highest levels of UV light through windows were 16% more likely to need cataract surgery than workers of the same age exposed to less light.
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