Many women in menopause report seeing their lives with greater clarity – their desires, their needs, their futures are clearer than ever before. Ironically, it’s also the time when actually seeing becomes more difficult because of dry eye and because post-menopausal women are at greater risk of developing cataracts.

Oh, estrogen – we really didn’t know what we had till it was gone, did we? In addition to all the other things it does for a woman, estrogen also protects her eyes from the damage of too much sun exposure and aging.

According to the American Academy of Ophthalmology, 24.4 million Americans aged 40 and up suffer from cataracts. Thanks to estrogen loss in menopause, women are disproportionately affected with cataracts, accounting for 61 percent of that number.

Since cataracts are common and prevalent, and because correcting cataracts could help you live longer, they are our Symptom of the Month.

What are cataracts?

As we age, the lens of our eyes can get cloudier and yellower, making our vision fuzzy and blurry and making colors appear less vibrant. Night vision can be especially impacted, as cataracts also make us more sensitive to glare.

What causes cataracts and how do I know if I have them?

Cataracts are usually age-related; most of us will develop them, if we live long enough.

There are environmental, lifestyle, health, and genetic factors that increase your risk of developing cataracts or developing them sooner: these include smoking, diabetes, high blood pressure, obesity, use of certain medications (steroids), over-exposure to ultraviolet radiation (usually sunlight but also tanning beds and even light therapy lamps), a family history of cataracts, and injury to the eye. And of course, being a woman in menopause.

Symptoms of cataracts include clouded or blurred vision that doesn’t correct when you blink. Halos around lights. Sensitivity to glare. Needing new prescriptions for your glasses often. Diminished contrast between colors. Difficulty seeing after dark. Double vision in one eye. If you notice any of these, get to an eye doc. And note that cataracts can develop so slowly that often we aren’t aware of the problem – a good reason to see your eye doctor regularly.

OK, my eye doctor says I have cataracts. Now what?

The quality of your vision can have a real impact on the quality of your life. Yet many of us are nervous about messing with our eyes, even if that “messing” can have a substantial positive outcome.

If that describes you, maybe this will help: “The best way I can describe how traumatic the experience can be is to tell you what most patients say to me as they walk in the door after the first procedure…. ‘When can I get the other eye done?’ The end result is so good that they cannot wait to get the other eye transformed as well.”  – Dr. Michael Hsu

Dr. Michael Hsu

For more information, we talked to Dr. Michael Hsu, optometrist and owner of Lakeview Vision Clinic in Seattle, about cataracts and what to do if you’ve got ’em.

Are cataracts difficult to treat?

Dr. Michael: Once cataracts become visually significant, surgery is the treatment of choice. There is now a tendency to treat cataracts early before the degrading vision is a problem for the patient. Some patients have difficulty reading, inability to see well in the distance despite updated prescription for glasses, and bothersome glare and reduced acuity with driving. Surgery is performed either in a surgery center associated with the eye surgeon’s office or in a hospital. Surgery without complication takes about 10 minutes.

Are there other treatments available?

Dr. Michael: There is no other good way of treating a cataract once it has become a problem. It is like a dirty window that cannot be cleaned.

What kind of difference can patients expect before and after?

Dr. Michael: Having a cataract can cause sensitivity to light especially with bothersome glare. Depending upon the location of the cataract relative to the center of one’s vision, it can be disruptive to reading comfortably or reading the text on a television monitor. I have had patients tell me that they have stopped reading as much as they previously did.

Surgery for cataracts is essentially a replacement of the opacified natural lens of the eye with an artificial lens implant. Cataract surgery has progressed now to where it is tantamount to refractive surgery. In other words, it is not a simple replacement that leaves you stuck with glasses. It is now possible to target the final prescription to what is desired. There are implants that correct astigmatism such that vision without glasses is possible at any desired distance.

Most people will want to have good distance vision and wear reading glasses; others, especially those who are presently nearsighted, may want to keep their innate ability to read up close without the glasses and wear them for distance. Now there are even good multifocal implants which allow for an excellent range of distance and near vision. A thorough discussion with your optometrist or ophthalmologist about desired post-surgical resultant vision is very important now.

Wait – you’re saying my vision can be better, and not just because the cataracts are gone?

Dr. Michael: Yep. That’s why it’s so important now. Being glasses-free is possible for some.

Will the lenses need to be replaced at some point in the future?

Dr. Michael: You’ll only need cataract surgery one time. That implant is good for the rest of your life. There is a secondary opacification that can occur usually some time after the surgery that requires a touch up treatment with a laser. This is nothing to fear, and once the hazy capsule behind the implant is removed, the patient has their clear vision back.

Is there anything I can do to prevent cataracts from developing?

Dr. Michael: Cataracts are thought to progress faster due to oxidative stress effects of free radicals, so eating food high in antioxidants would be useful in prevention. Adding more colorful fruits and vegetables is a simple way to improve your diet. Higher intake of vitamin C has been studied as helpful. Sunlight adds to the oxidative stress, so shielding your eyes by using UV protective sunglasses is also recommended.

sunglasses on a white table

There is also some reason to believe hormone replacement therapy could aid in preventing or minimizing cataracts.

Does that ringing in your ears affect your life? Learn more about tinnitus, menopause, and ways to handle the noise.

Is it worth getting treatment for cataracts?

If you’re not yet convinced, consider this: according to The New York Times, treating cataracts can add years to your life. A 20-year study of over 74,000 women 65 and older showed a 60 percent lower risk of death for those who had cataracts removed.

Why? Researchers don’t really know why, exactly, though there are several possibilities: if you can see better, you’re more likely to exercise and be social, especially if cataracts had limited your ability to drive after dark. You’re less likely to trip and fall, meaning fewer broken bones and hospitalizations. You may also be more able to read labels and medicine bottles, meaning better adherence to medical regimens and better diet.

The surgery has a 98 percent success rate with few risks, says The NYT, and recovery usually involves taking some simple precautions for a few weeks after surgery (no heavy lifting, no swimming, antibiotic drops). And many insurance policies will cover the basic surgery, though vision-correcting lenses may cost more out-of-pocket.

One of the most important things you can do to protect your eyes, says Dr. Michael, is see your eye doctor every year after you turn 40. The earlier cataracts are diagnosed, the simpler they are to remove.

For more information on common menopause-related conditions like frozen shoulder, itchy skin, restless leg syndrome, night sweats and more, check out our menopause Symptom of the Month series on genneve. You may discover that weird thing that’s happening to you (body odor? cold flashes??) aren’t just you after all.

Have you been diagnosed with cataracts and decided for or against the surgery? We’d like to hear about your decision and how things turned out for youLeave us a comment below, or talk to us on our Facebook page or in Midlife & Menopause Solutions, our closed Facebook group.

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Shannon Perry

Shannon is a celebrated author and global educator. Whether she’s interviewing a physician or producing a podcast, her appetite for research, facts, and truth culminates in credible health education and programming that women can rely on. An avid runner, cyclist, and climber, Shannon knows a thing or two about thriving in midlife and lives in Seattle with her cat, dog and boyfriend.

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