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Cataract in adults

Deborah S Jacobs, MD
Section Editor
Jonathan Trobe, MD
Deputy Editor
Howard Libman, MD, FACP


Cataract is the leading cause of blindness in the world [1]. A cataract is an opacity of the lens of the eye that causes partial or total blindness. The word derives from the Latin "catarractes," which means "waterfall"; to the naked eye of an observer, the foamy white opacity of an advanced cataract, seen through the pupil, resembles the turbulent water of a waterfall.

Modern microsurgical technique allows intervention for cataract before it has resulted in blindness; normal vision typically is restored with intraocular lens implantation [2]. Except in certain very uncommon situations, delay in treatment does not result in an adverse outcome. The major advances in the surgical treatment of cataract in the last century have not been matched by advances in the understanding of cataract formation, in approaches to prevention, or in nonsurgical therapy.


Epidemiologic models estimate that there are approximately 30 million blind people in the world, 50 percent of whom are blind due to cataracts [3]. The pattern and rate of blinding disorders is different in developed and developing nations depending upon whether nutritional and infectious causes of blindness are eradicated and whether there are resources available for treatable disorders such as cataract.

The definition of blindness is different for international health purposes than it is for social and rehabilitative purposes in the United States. The least-developed nations are estimated to have a 1 percent rate of blindness using the international definition; developed nations are thought to have a 0.2 percent rate of blindness. Blindness by international health standards is defined as the inability to count fingers at 10 feet; this converts to 10/200 by Snellen notation, which means that a patient can see at 10 feet what a normal person would see at 200 feet. This level of vision allows ambulation but does not allow the reading of print of any size. The standard for legal blindness in the United States is 20/200. This standard is lower than the international standard, meaning it is easier to qualify as "blind." Individuals with 20/200 vision can ambulate, and some can read print with appropriate low-vision aids.

The Eye Diseases Prevalence Research Group (EDPRG) estimated causes of blindness and visual impairment in the United States by applying the results of population-based studies conducted in North America, Western Europe, and Australia between 1990 and 2001 to the population structure of the United States based on the year 2000 census [4]. The EDPRG estimated that 0.78 percent of people older than age 40 in the United States were blind by the US definition and an additional 1.98 percent had low vision, with a best corrected visual acuity between 20/40 and 20/200. Cataract was associated with approximately 50 percent of cases of low vision. Using a definition of cataract that did not require visual impairment, the EDPRG estimated that in 2000 there were 20.5 million people over 40 in the United States (17.2 percent) with cataract in either eye and projected that this number would rise to 30.1 million by 2020 [5].

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Literature review current through: Nov 2017. | This topic last updated: Aug 30, 2017.
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