Risk factors for the development of cataracts

A recent study involving approximately 4500 patients has helped elucidate known risk factors for cataract formation.  This study known as the AREDS study for age related eye disease involved male and female patients from the ages of 55 to 80 years old.  This was a geographically diverse population followed for nearly 10 years.  Three different types of cataracts were evaluated; cortical, or dense spokes found within the natural lens of the eye, nuclear, or densities within the substance of the lens, and posterior subcapsular which are densities that form in the back of the lens.

Aging was considered a major risk factor for all types of cataracts.  This may be due to environmental influences such as sun damage, deterioration of defense and repair mechanisms, and genetic predisposition.

Women seem to be at a greater risk for cortical cataracts and interestingly estrogen replacement therapy may help reduce the incidence of both nuclear as well as cortical lens changes.

Race is another factor associated with cataract formation with non-whites, especially blacks having a greater risk for cortical cataracts.  Whites on the other hand underwent greater rates for undergoing cataract surgery which may reflect better access to health care.

Interestingly higher education is associated with a lower prevalence for cataract formation which may reflect a healthier lifestyle lead by people at higher socioeconomic levels.

Smoking is a major risk factor for both cortical and nuclear cataracts.  The good news is cessation of smoking can reduce your risk for requiring surgery later in life.  Disease states such as diabetes are associated with much greater rates of cortical and posterior subcapsular lens changes.  The use of cortisone or prednisone likewise is associated with posterior subcapsular cataracts.

Another surprising risk factor is change of weight, either gaining or losing weight which is significantly associated with cataract formation.  This change in weight must be significant, however, at least 53 pounds.

For those health conscious people people who like to take vitamins the use of centrum vitamins was actually shown to decrease nuclear cataract formation.  The ability of nonsteroidal anti-inflammatory agents including aspirin to prevent cataracts apparently is less certain.