What happens in the late stages of cataracts?

Nov 19, 2025 Source: Cainiu Health

Dr. Wang Lei

Introduction

In the late stages, cataracts generally lead to severe vision loss, cause eye pain, trigger secondary glaucoma, and result in corneal edema. When lens opacity reaches an advanced stage, light has difficulty entering the eye, leading to significant visual deterioration. Patients may only be able to perceive light and darkness, unable to discern object outlines, and may even approach a state of near blindness, severely affecting basic daily activities such as walking and eating.

Advanced cataracts generally lead to severe vision loss, eye pain, secondary glaucoma, corneal edema, and increased treatment difficulty. The details are as follows:

1. Severe vision loss: In the late stages, the lens becomes so cloudy that light struggles to enter the eye. Patients experience significant vision decline, possibly only perceiving light and dark without being able to discern object outlines, or even approaching blindness. This severely affects basic daily activities such as walking and eating.

2. Eye pain: In advanced cataracts, the lens may swell and push the iris forward, blocking the drainage angle and obstructing aqueous humor outflow. This leads to elevated intraocular pressure and causes intense eye pain, which may radiate to the head, accompanied by symptoms like eye swelling and headache.

3. Secondary glaucoma: Persistent high intraocular pressure caused by lens swelling can progress to secondary glaucoma. Prolonged elevated pressure damages the optic nerve, resulting in visual field defects. This type of optic nerve damage is typically irreversible and further worsens vision loss.

4. Corneal edema: High intraocular pressure or dislodged opaque lens material may compress or irritate the cornea, leading to corneal tissue swelling. This reduces corneal transparency, causing patients to see a foggy haze and further deteriorating vision. It may also cause a foreign body sensation in the eye.

5. Increased treatment difficulty: In advanced cataracts, the lens becomes harder, making lens removal more difficult during surgery. This may prolong surgical time and increase the risk of complications such as postoperative infection and corneal astigmatism, negatively affecting postoperative recovery.

Once cataracts progress to an advanced stage, prompt medical evaluation for surgical feasibility is essential to avoid delaying treatment and developing serious complications. Prior to surgery, protect the eyes from trauma and maintain good ocular hygiene. After surgery, follow medical instructions for eye care and attend regular follow-up appointments to monitor vision and eye recovery, promoting optimal visual rehabilitation.

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What are the nursing diagnoses for cataracts?

Nursing diagnoses for cataracts generally include altered sensory perception (decreased vision), risk for injury, anxiety, knowledge deficit, and potential complications (postoperative infection). Altered sensory perception (decreased vision): due to lens opacity causing abnormal light refraction, patients experience progressive vision loss, manifesting as blurred vision and double vision, which affects daily activities such as reading and walking.

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What is the name of cataract in traditional Chinese medicine?

In traditional Chinese medicine (TCM), cataracts are known as "yuanyi neizhang," an eye disorder characterized primarily by lens opacity and progressive vision loss. TCM attributes the condition to aging, physical weakness, and disharmony of internal organs. If symptoms such as sudden vision decline, eye pain, or visual distortion occur, prompt medical evaluation is recommended. The underlying pathological mechanism in TCM is deficiency of the liver and kidneys, accompanied by insufficient qi and blood.