Nuclear sclerosis is common in older adults as part the aging process of the eye. However, it can lead to severe complications like nuclear sclerotic cataracts in which the clouding of the lens causes significant blurring and vision loss.
Nuclear sclerosis tends to be progressive, although the changes can be more profound in some people than in others.
This article describes the symptoms and causes of nuclear sclerosis and how it can contribute to the development of cataracts. It also describes how nuclear sclerosis is diagnosed and treated and ways to better manage the condition if affected.
Nuclear Sclerosis Symptoms
Early on, symptoms of nuclear sclerosis can be subtle. It may take a long time for you to notice them.
They can include:
Worsening vision (especially distance) that doesn’t improve with glasses or contactsNeeding frequent updates to your lens prescriptionBlurry, unfocused vision (“clouding”)Colors and shadows appearing less vivid"Haloes" or rings around light sources; seeing a glareTrouble seeing at night, especially when driving
Some people with nuclear sclerosis see a temporary improvement in their vision. This is sometimes called second sight. It can make you think your eyes have gotten better, but the slow decline inevitably continues.
Nuclear Cataract Symptoms
With nuclear cataracts, the center of the eye’s lens becomes thick and discolored. Symptoms and signs of nuclear cataracts include:
Noticeable changes in the appearance of the affected eye(s), including cloudiness, yellow, or browningBlurred and cloudy visionHaloes around lightsWashed-out colors
At first, you may get a cataract in just one eye. Over time, you’ll likely develop one in the other eye, too. Vision may improve, only to decline again.
Nuclear cataracts can be classified as either immature or mature, depending on how severe the clouding is. In severe cases, untreated nuclear cataracts can cause blindness.
Cataracts are the leading cause of blindness both in the United States and around the world.
Causes of Nuclear Sclerosis
Nuclear sclerosis is caused by proteins in your eye lens that naturally break down over time. They clump together and cause hardening that impedes light from passing through the center of the lens to the retina.
The retina processes light and transfers signals that allow your brain to register images. Less light going through the center of the lens due to nuclear sclerosis means less “information” for the retina to translate. That, in turn, equates to vision issues.
As you age, your nuclear sclerosis will eventually develop into an NS cataract. In addition to aging, cataracts can be caused by trauma or disease.
Age-related cataracts are extremely common and nuclear sclerotic cataracts are the most common kind. Other types of cataracts result from changes to different parts of the lens.
To differentiate them from other types of cataracts, NS cataracts caused by age are sometimes referred to as nuclear senile cataracts.
Risk Factors
Age is the main risk factor for nuclear sclerotic cataracts. Other risk factors include:
Smoking or other tobacco use Heavy alcohol use Steroid drugs Eye trauma or diseases Excessive exposure to UV light (sunlight) or radiation Other health conditions including diabetes, high blood pressure, chronic kidney disease, autoimmune disease, nutritional deficiency, and obesity A relative who had cataracts early in life
Diagnosis
If you have symptoms that could point to nuclear sclerosis, see an eye doctor (ophthalmologist).
Nuclear cataracts are typically easy to diagnose. That’s especially true if they’ve changed how the lens looks.
Healthcare providers use special eye drops to dilate (widen) your pupil. Then they look inside your eye with a handheld instrument called an ophthalmoscope and a slit-lamp microscope. If you have nuclear sclerosis, the healthcare provider will see abnormalities in the lens’s nucleus.
They’ll also perform refraction (vision prescription) and acuity (eye chart) tests on both eyes to check your vision’s clarity and sharpness.
Sometimes an eye health professional can see early changes before you have noticeable symptoms. This reinforces the importance of routine eye exams. Early diagnosis means early treatment, and that may prevent or delay serious vision loss—including blindness.
Treating Nuclear Sclerosis
Early on, glasses or contacts may be all you need to help manage symptoms of nuclear sclerosis. You may also find it helpful to:
Use brighter light bulbsWear anti-glare sunglassesUse a magnifying lens for reading and close-up activities
Eventually, healthcare providers may be able to treat nuclear sclerosis with eye drops. Treating it in the early stages may prevent nuclear cataracts from forming. For now, though, this treatment is experimental.
Cataract Surgery
Healthcare providers generally suggest surgery when the above options aren’t sufficient and nuclear cataracts significantly impact your life (e.g., make you unable to drive).
Cataract surgery involves removing the cloudy lens and replacing it with a clear synthetic one that is created especially for your eye. It is considered safe for most people.
If you have nuclear sclerotic cataracts in both eyes, they will probably be removed during separate procedures done about a week apart. Most people fully recover in about eight weeks.
Cataract surgery has a 97% or higher success rate.
Summary
Nuclear sclerotic cataracts impact the center of your eye’s lens. With age (or sometimes, eye disease), the lens thickens, becomes cloudy, and impairs your vision.
Symptoms include blurry vision (especially at night), frequent updates to your corrective lenses, and colors appearing less vivid.
Healthcare providers diagnose nuclear sclerosis with a dilated eye exam. Treatment includes corrective lenses or, later on, surgery to replace the affected lens.
A Word From Verywell
With treatment, nuclear sclerosis and nuclear sclerotic cataracts rarely cause blindness. Getting regular eye exams is key to early diagnosis and treatment, which can help preserve your vision.
As you get older, don’t skip these exams and be sure to tell your healthcare provider about any vision changes.
