Cataract is the most common cause of reversible blindness in the world. In India, it accounts for roughly half of all blindness. The good news: it is entirely treatable. A straightforward surgical procedure, done as a day case under local anaesthesia, can restore vision that has been diminishing for years.

Cataract develops when the natural lens of the eye, which sits behind the iris and is normally transparent, becomes cloudy. Light can no longer pass through cleanly. The result is a progressive blurring and dimming of vision that no glasses can fully correct.

Most cataracts are age-related. But cataract is not exclusively a disease of old age.

Dr Shibal Bhartiya explains. She is a fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator with over 25 years of experience. Her approach focuses on identifying risk before damage is irreversible, simplifying treatment decisions, and protecting vision long-term. Emphasis on early detection, risk assessment, and continuity of care. She is rated 5 stars across 1,500+ patient reviews on Google.

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What Causes Cataract?

Age is the commonest cause. The lens proteins break down gradually over decades, clumping together and losing their transparency. Almost everyone will develop some degree of lens clouding by their seventies.

Diabetes accelerates cataract formation significantly. Patients with poorly controlled blood sugar develop cataracts earlier and faster than the general population. If you have diabetes and notice a rapid change in your glasses prescription, get your eyes examined promptly, this can be an early sign of diabetic lens changes. You can read more about diabetes and the eye here.

Steroids: both oral and topical (including steroid eye drops used long-term) are a well-recognised cause of posterior subcapsular cataract. This type of cataract affects near vision and causes significant glare. If you are on long-term steroid treatment for any reason, annual eye examinations are important.

Eye trauma can cause cataract at any age. A blunt or penetrating eye injury can damage the lens directly, or disrupt the capsule that holds the lens in place, leading to rapid clouding.

Congenital cataract is present at birth or develops in early childhood. It must be identified and treated early to prevent amblyopia, the permanent visual impairment that occurs when a child’s visual system does not develop normally because a clear image is not reaching the retina.

UV radiation and smoking both increase oxidative stress on the lens and contribute to earlier cataract development.

Previous eye surgery including certain glaucoma surgeries, can accelerate cataract formation.

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Symptoms of Cataract

Cataract develops slowly. Most people adapt gradually and do not notice the change until it is significant. The classic symptoms are:

• Blurred or hazy vision that is not corrected by a change of glasses
• Reduced vision in dim light and difficulty driving at night
• Glare and halos around lights, especially headlights and streetlights
• Frequent changes in glasses prescription
• Fading or yellowing of colours
• Double vision or ghost images in one eye
• A feeling that you need brighter light to read

One early sign worth knowing: some people with a developing nuclear cataract experience temporary improvement in near vision, sometimes called “second sight.” Reading glasses that were previously necessary are suddenly not needed. This improvement is short-lived and followed by deterioration.

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When Should You Have Cataract Surgery?

The decision to operate is based on two things: how much the cataract is affecting your daily life, and whether any other eye condition is present that may complicate surgery or limit the visual outcome.

There is no universal threshold. A cataract that prevents a surgeon from driving or a teacher from reading the board is a different functional problem than the same density of opacity in someone with less visually demanding work.

Your doctor may recommend earlier surgery if:

• The cataract is dense enough to prevent adequate examination or treatment of the retina or optic nerve, particularly relevant in glaucoma patients
• A mature or hypermature cataract is causing raised eye pressure (phacomorphic glaucoma)
• A congenital cataract is threatening normal visual development in a child

Not sure about your diagnosis? You are not alone.

Many patients come to Dr Bhartiya after receiving a diagnosis elsewhere: unsure whether to start treatment or surgery, concerned about long-term progression, or simply wanting clarity before committing to a plan.

A second opinion is not a sign of distrust. It is good medicine.

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Cataract Surgery in Gurgaon

All modern cataract surgery is performed as a day case, under topical anaesthesia (eye drops, no injections around the eye in most cases), and takes 15 to 30 minutes per eye.

Phacoemulsification

This is the standard of care worldwide and the most commonly performed cataract surgery. A small incision of approximately 2.2 mm is made in the cornea. An ultrasound probe breaks the cloudy lens into tiny fragments, which are then aspirated out of the eye. A foldable intraocular lens (IOL) is inserted through the same incision. The wound is self-sealing. This means that no stitches are needed. Recovery is fast, with most patients seeing clearly within a day or two.

Microincision Cataract Surgery (MICS)

A refinement of phacoemulsification, MICS uses an incision of 1.8 mm or smaller. The smaller wound causes less surgically-induced astigmatism and heals faster. It is the preferred technique in most modern cataract centres.

Femtosecond Laser-Assisted Cataract Surgery (FLACS)

A laser is used to perform several of the initial steps of surgery: the corneal incision, the opening of the lens capsule (capsulotomy), and the pre-fragmentation of the lens, with a precision that the human hand cannot replicate. The remaining steps are completed with standard phacoemulsification. FLACS is particularly useful when premium IOLs are being implanted, as the precision of the capsulotomy improves lens centration. You can read more about femtosecond laser-assisted cataract surgery here.

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Choosing Your Intraocular Lens (IOL)

The IOL that replaces your natural lens is a permanent implant. Choosing the right one is an important decision.

Monofocal IOL: the standard IOL. It corrects vision at one distance, usually set for distance. You will need reading glasses after surgery. Covered by most insurance.

Multifocal IOL: corrects vision at multiple distances using different zones in the lens. Many patients achieve spectacle independence for both distance and near. Trade-offs include some loss of contrast sensitivity and potential for glare or halos at night. Not suitable for everyone, particularly those who drive extensively at night or have certain corneal conditions.

Toric IOL: corrects pre-existing astigmatism at the time of cataract surgery. If you currently need a cylindrical component in your glasses, a toric IOL can address this and reduce your dependence on glasses for distance vision.

Extended Depth of Focus (EDOF) IOL: a newer lens design that provides a continuous range of clear vision from distance to intermediate, with fewer halos than traditional multifocal lenses. Good for patients who spend significant time at a computer.

Monovision: an alternative approach where one eye is corrected for distance and the other for near, using monofocal lenses. Some patients adapt extremely well; others find it uncomfortable. A trial with contact lenses before surgery can help predict how you will tolerate it.

Your surgeon will discuss which option suits your eye measurements, lifestyle, and visual demands.

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Cataract Surgery and Glaucoma

These two conditions frequently coexist, and their interaction is clinically important. A few key points:

Cataract surgery can lower intraocular pressure modestly in many patients. In eyes with narrow angles or angle-closure glaucoma, removing the thick natural lens can open the drainage angle significantly, reducing pressure. For some patients, cataract surgery alone may reduce the need for glaucoma drops.

Conversely, certain glaucoma surgeries, particularly trabeculectomy, can accelerate cataract formation. If you have had glaucoma surgery in the past, discuss the implications for your surgical approach with your ophthalmologist before cataract surgery.

Combined cataract and glaucoma surgery is sometimes appropriate. Minimally invasive glaucoma surgery (MIGS) procedures can be performed at the same time as cataract surgery, lowering eye pressure while restoring vision in a single operative episode. Read more about glaucoma surgery options here.

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After Cataract Surgery: What to Expect

• Vision improves within 24 to 48 hours for most patients
• Antibiotic and anti-inflammatory eye drops are prescribed for 4 to 6 weeks
• Avoid rubbing the eye
• Avoid swimming and dusty environments for two to four weeks
• Driving may resume once your doctor confirms adequate visual acuity in the operated eye
• Final glasses prescription is given 4 to 6 weeks after surgery, once the eye has stabilised

A small percentage of patients develop posterior capsular opacification (PCO), sometimes called “secondary cataract”, months to years after surgery. This is not a recurrence of the original cataract. It is a thickening of the membrane behind the IOL, and is treated very simply with a brief laser procedure (YAG capsulotomy) in the outpatient clinic.

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Prevention

Cataract cannot be prevented entirely. But the following reduce your risk or slow progression:

• Control blood sugar if you have diabetes
• Wear UV-protective sunglasses outdoors
• Stop smoking
• Avoid long-term steroid use without ophthalmological monitoring
• Annual eye examinations after the age of 40

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Frequently Asked Questions

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What are the early signs of cataract?

Early cataract causes blurred or cloudy vision, increased glare, and frequent changes in your glasses prescription. Colours may appear faded or yellowed.

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At what age does cataract usually develop?

Cataract most commonly develops after age 50 as part of natural ageing. It can also affect younger adults, children, and rarely, newborns.

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Is cataract surgery safe?

Phacoemulsification is one of the most commonly performed and safest surgeries in the world. Most patients return to normal activities within a few days.

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Will I need glasses after cataract surgery?

This depends on the lens implanted. A standard monofocal lens corrects distance vision. A multifocal lens reduces dependence on glasses for both distance and near work.

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Can cataract come back after surgery?

The cataract itself does not return after surgery. Some patients develop a secondary cloudiness called posterior capsule opacification. This is easily treated with a laser procedure.

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How do I know if my cataract needs surgery now?

Surgery is recommended when the cataract affects your daily activities — driving, reading, or working — regardless of how it looks on examination.

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Can cataract and glaucoma occur together?

Yes. Cataract and glaucoma frequently coexist, especially in older adults. Both conditions require separate evaluation and sometimes benefit from combined surgical management.

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What is the difference between phacoemulsification and MICS?

Phacoemulsification uses a 2.2mm incision. MICS (Microincision Cataract Surgery) uses a smaller 1.8mm incision. MICS causes less astigmatism and allows faster healing.

Read the research articles

This article was written by Dr Shibal Bhartiya, fellowship-trained glaucoma specialist and Mayo Clinic Research Collaborator, Clinical Director at Marengo Asia Hospitals, Gurugram, known for ethical, patient-centred glaucoma care and independent glaucoma second opinions. This article was edited in April 2026.

She has published peer-reviewed research on eye care, examining how treatment decisions should balance medical evidence, patient preferences, and long-term vision outcomes.

As Editor-in-Chief of Clinical and Experimental Vision and Eye Research and Executive Editor of the Journal of Current Glaucoma Practice (Pubmed Indexed, official journal of the International Society of Glaucoma Surgery), Dr Shibal Bhartiya brings editorial and research depth to every clinical decision. Her 200+ publications, including 90+ PubMed-indexed publications and 28 edited textbooks span glaucoma biology, surgical outcomes, health equity, and emerging diagnostics.

Her work can be accessed on Pubmed, Google Scholar, ResearchGate and ORCID.

Dr Shibal Bhartiya
Glaucoma • Second Opinion • Advanced Care

www.drshibalbhartiya.com
 +91 88826 38735

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