From the wise words of Dr. O’Donoghue: “Everyone is bound to get a cataract at 55.”

I started my first clinical rotation at Commonwealth Ave with a basic understanding of cataracts. I expected older patients to report glare, blurry vision, and reduced contrast. I could identify nuclear sclerotic cataracts and knew what a posterior chamber intraocular lens (PCIOL) looked like under the slit lamp. But that was about the extent of my knowledge as a second-year student.

As I continued my rotations through the Community Health Centers in Boston, I began to recognize the subtle differences between cataract types. I learned that anterior cortical changes become clearer after dilation, and posterior vacuoles are easier to spot on retroillumination.

One of the most memorable patients I saw was someone who had cataract surgery a few years back. He had opted for monovision implants, using one eye for distance and the other for near vision. He was happy with the results and appreciated the freedom from glasses, a success story that reminded me just how life-changing this procedure can be.

Now that I’m working at the VA, nearly all my patients either have cataracts or have already undergone surgery. Just recently, I saw a patient whose vision had dropped from 20/30 to 20/100 in one year. He also noted increased glare that had worsened over just a few months. A review of his chart revealed a prescription for a steroid cream, which he applied near his nose for a skin condition. Slit lamp exam revealed dense posterior subcapsular cataracts more severe on the same side as the cream application. We discussed how this type of cataract progresses quickly and how topical steroids likely contributed to its formation. He was referred to ophthalmology for surgical evaluation.

Cataracts are one of the most common conditions we see in clinic. Still, many patients are unaware of how cataracts affect vision or that surgery is often quick, safe, and highly effective. As future eye care professionals, it’s our job to educate, reassure, and guide our patients through the process.

So, whether you’re protecting your eyes from UV or helping a patient navigate surgery options, remember, cataract care can be a lifelong conversation even before they turn 55.

Happy Cataract Awareness Month! 👁️ ☀️