Vision & Eye Health

By CalBroker

Cataracts and refractive errors are common conditions. Over half of all Americans aged 80 years and older have cataracts, while 150 million have a refractive error.

Simple treatments can help with these conditions, but people may eventually need advanced cataract treatment. Understanding these conditions, the symptoms, and the typical medical care can help you find the best vision insurance for your clients.

What Are Cataracts and Refractive Errors?

Cataracts and refractive errors are eye conditions that cause vision problems. Refractive errors may be a standalone condition or a symptom of cataracts.

Cataracts

Cataracts are a progressive eye disease that causes the normally clear lens of the eye to cloud over, limiting the passage of light to the retina. There are many types and causes of cataracts. Your clients may develop cataracts:

• At birth, as a side effect of certain infections or the mother’s nutrition

• As part of aging

• As a complication of another disease, such as diabetes

• From an injury to the eye

• As side effects of some medications

• From chemical injuries or exposure to UV light

• From poor nutrition, smoking, or alcohol use

The lens is made of fibers and is inside a membrane called the lens capsule. These fibers break down for various reasons, and proteins clump inside this capsule, building up and turning the lens from clear to cloudy.

Cataracts usually develop slowly and worsen with time, especially without treatment. This eye disease is more prevalent in women than men and can make daily activities difficult.

Refractive Errors

Refractive errors are a common condition in which the shape of the eye prevents light from hitting the back of the eye directly, leading to blurriness. These errors may also develop from a thicker or thinner lens, a flatter eye surface, or an eye that’s too short or too long.

• There are several types of refractive errors, including:

• Myopia or nearsightedness, where items far away look blurry

• Hyperopia or farsightedness, where items close up look blurry

• Astigmatism, where objects close or far look blurry or distorted

• Presbyopia, where older people have trouble seeing items up close

Cataracts may lead to refractive errors as the cloudiness affects the lens and changes how light hits the back of the eye. For example, age-related cataracts typically cause nearsightedness, while other forms may also lead to astigmatism.

Symptoms of Cataracts and Refractive Errors

The main symptoms of refractive errors are blurriness and distorted vision, either with objects far away, up close, or both. They may also cause headaches, squinting, glares or halos around lights, tired or sore eyes, and trouble focusing. Refractive errors may also be a symptom of cataracts.

However, cataracts come with other symptoms, including:

• Sensitivity to glare

• Glare or rainbow halos around lights

• Worsening nearsightedness that may cause frequent changes in prescription glasses

• Double vision

• Blurry or cloudy vision

• Poor night vision

• Colors appear faded

• Cataracts may also lead to blindness without treatment and are one of the most common causes of blindness worldwide.

Diagnosis

• A healthcare provider can diagnose both conditions based on clinical information. They may take a history of your client’s health and symptoms and perform several eye tests to assess vision and check eye health.

• Typical tests include:

• Pupil dilation, where they apply eye drops to widen the pupil and look at the retina and optic nerve

• Visual acuity, or the eye chart test that measures vision

• Slit-lamp, a microscope with an intense light to check the cornea, iris, and lens

• Tonometry, to check the pressure inside the eye

The healthcare provider may easily see a cloudy or gray lens, though it may also look dark brown, black, or yellow.

Treatments for Cataracts and Refractive Errors

The simple treatment for refractive errors is to wear glasses or contact lenses. These temporary lenses bend light so it hits the back of the eye or the retina directly and produces clear vision. Laser surgery is another option, which corrects the eye shape to eliminate or reduce the refractive error.

Treatment in the early stages of cataracts starts with new glasses, other vision aids, and lifestyle adaptations. Eventually, surgery may be necessary as vision worsens.

Vision Aids

Simple habits or tools can help patients with cataracts adjust to changing vision, and these vision aids are the most common treatment early in the disease. Vision aids include:

• Bright lights for reading or work

• Magnifying lens to help with reading or other tasks

• Anti-glare sunglasses

• Patients may also need new prescription glasses or contact lenses and may need to change them frequently.

• Surgery

If cataracts progress and cause worsening vision that interferes with daily living, surgery is necessary. Cataract surgery is one of the most common procedures in the U.S. and is safe and effective.

The procedure is simple. A surgeon makes a small cut in the cornea—which is the dome-shaped surface that covers the eye—and removes the cloudy lens. Then, they insert a clear artificial lens to improve vision.

Prevention

Simple lifestyle changes and habits can help prevent cataracts from developing. Your clients can:

• Quit smoking

• Eat a healthy diet of leafy greens, nuts, whole grains, fruits, and vegetables

• Limit alcohol use

• Wear sunglasses to protect the eyes

• Manage underlying conditions

• Local Resources

Several organizations offer education, eye exams, new glasses or contact lenses, or free cataract surgery to patients without insurance, with limited insurance, or who can’t pay. These include:

• EyeCare America: Offers no-cost exams and eye care to people aged 65 and older

• Lions Club SightFirst: Provides gift certificates for exams or frames and lenses for those without insurance or limited insurance

• Mission Cataract USA: Performs free cataract surgeries for individuals who are unable to pay

• Quit Day: A government program aimed at helping people quit smoking, which can help prevent cataracts

• Tang Center: A university clinic offering treatment by medical students and specialty referrals for complex care

• Discussing Vision and Eye Care Insurance With Clients Cataracts and refractive errors require regular exams and health care for monitoring and treatment. In particular, aging clients may need additional coverage to secure the appropriate treatment. Assessing your client’s health and lifestyle patterns can help you understand their needs and find the best plan.

SOURCES:

StatPearls Publishing: “Cataract.”

Johns Hopkins Medicine: “Refractive Errors.”

British Journal of Ophthalmology: “Refractive Error Changes in Cortical, Nuclear, and Posterior Subcapsular Cataracts.”

University of Rochester Medical Center: “Cataracts.”