What are the symptoms of severe cataracts?
Nov 19, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
Severe cataracts typically present with significant vision loss, markedly increased dark spots in the visual field, abnormal color perception, worsened monocular diplopia or polyopia, photophobia, and day blindness. Patients experience substantial deterioration in vision, sometimes to the extent of only being able to perceive hand movements or light, making it impossible to recognize everyday objects, road signs, or faces, severely affecting basic daily activities such as walking and eating.
Severe cataracts typically present with significant vision loss, markedly increased dark spots in the visual field, abnormal color perception, worsening monocular diplopia or polyopia, photophobia, and day blindness. The details are as follows:
1. Severe vision loss: Patients experience a substantial decline in visual acuity, sometimes limited only to being able to perceive hand movements or light. They may be unable to recognize everyday objects, road signs, or faces, severely affecting basic activities such as walking and eating. Sensitivity to changes in lighting also becomes diminished.
2. Markedly worsened dark spots in the visual field: Pre-existing floaters or dark shadows may enlarge and darken, covering a large portion of the visual field. These shadows remain fixed in position and continue to interfere with vision even in bright environments, resulting in large blind or dark areas within the visual field.
3. Abnormal color perception: Objects appear dull or yellowish, and patients may experience color distortion—such as seeing red as dark red or blue as grayish-blue. The ability to distinguish vivid colors is impaired, leading to an overall hazy and dim visual experience.
4. Worsening monocular diplopia or polyopia: Due to severe and uneven lens opacity causing disordered light refraction, patients may see double or even multiple overlapping images when using one eye. Even simple stimuli like lights or text become difficult to identify clearly due to the persistent double vision.
5. Photophobia and day blindness: Lens opacity causes light scattering, making patients extremely sensitive to bright light. In daylight or under strong illumination, they may experience intense glare, squinting, or even an inability to open their eyes. Some patients develop "day blindness," where their vision is worse during the day than at night.
When these severe symptoms occur, prompt evaluation at a professional ophthalmic facility is essential to assess the degree of lens opacity. If surgical criteria are met, timely cataract surgery should be performed to prevent irreversible vision damage due to delayed treatment.
