When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Cataracts

Last reviewed: 21 Oct 2024
Last updated: 14 Nov 2023

Summary

Definition

History and exam

Key diagnostic factors

  • subjective decrease in vision
  • blurred or cloudy vision
  • glare
  • washed-out color vision
  • reduced visual acuity
  • defects in the red reflex
Full details

Other diagnostic factors

  • inadequate glasses prescription
  • disruption of activities of daily living
Full details

Risk factors

  • age >65 years
  • female sex
  • smoking
  • long-term UV exposure
  • diabetes mellitus
  • other metabolic or hereditary conditions
  • exposure to ionizing radiation
  • eye trauma
  • long-term corticosteroid use
  • family history of congenital cataract or congenital influences (e.g., toxins)
  • uveitis
  • myopia
Full details

Diagnostic tests

1st tests to order

  • dilated fundus exam
  • measurement of intraocular pressure
  • glare vision test
  • slit lamp exam of the anterior chamber
Full details

Tests to consider

  • assessment of best visual potential
Full details

Treatment algorithm

ACUTE

cataract without concomitant eye pathology

cataract with concomitant eye pathology

ONGOING

postsurgical opacification of the posterior capsule + significant visual impairment

Contributors

Authors

Robert T. Chang, MD

Associate Professor of Ophthalmology

Byers Eye Institute

Stanford University School of Medicine

Stanford

CA

Disclosures

RTC declares that he is a consultant for Alcon which makes cataract equipment..

Acknowledgements

Dr Robert T. Chang would like to gratefully acknowledge Dr Creig Hoyt, Dr Leela V. Raju, and Dr M. Bowes Hamill, previous contributors to this topic.

Disclosures

CH, LVR, and MBH declare that they have no competing interests.

Peer reviewers

Michael P. Ehrenhaus, MD

Assistant Professor of Ophthalmology

Cornea External Disease and Refractive Surgery Local Director

Long Island College Hospital Eye Center

Brooklyn

NY

Disclosures

MPE declares that he has no competing interests.

Parwez Hossain, PhD, FRC Ophth, FRCS(Ed)

Associate Professor/Consultant in Ophthalmology

University of Southampton

Southampton

UK

Disclosures

PH declares that he has no competing interests.

Bob Avery, MD, PhD

Assistant Professor

Ophthalmology

University of New Mexico Medical School

Albuquerque

NM

Disclosures

BA declares that he has no competing interests.

  • Cataracts images
  • Differentials

    • Refractive error
    • Dry eye
    • Glaucoma
    More Differentials
  • Guidelines

    • Pediatric eye evaluations: preferred practice pattern
    • Vision rehabilitation: preferred practice pattern
    More Guidelines
  • Patient information

    Cataracts: should I have surgery?

    Cataracts: questions to ask your doctor

    More Patient information
  • padlock-lockedLog in or subscribe to access all of BMJ Best Practice

Use of this content is subject to our disclaimer