Factors responsible for the growing incidence of cataract among young adults in India

Cataract is an eye disorder generally associated with older people. Most of us have memories of our grandparents undergoing a treatment for cataract.

But in the recent times, to my utter shock, the average age of our cataract patients has gone down drastically. Statistics also indicate that the percentage of youth affected by cataract in India is far greater than that of our industrialized counterparts. At REH, we are noticing more and more youngsters coming in with complaints about irritation, inflammation and redness in eyes etc. A significant number of them are detected with cataract.

Recently, I had a patient, a young executive of 37 years of age. He complained of a blinding glare while driving at night, being unable to read the small print on his laptop, difficulty in reading and replying to text messages on his mobile phone. He added that all these were activities which he was able to perform with ease until the recent past.

After examining his eyes, I discovered that he had cataracts in both of his eyes.

Now, there are certain factors which have been established to be responsible for cataract in young adult:

  1. Environmental factors: Prolonged exposure to UV light, severe dehydration from heat stroke or diarrhea.
  2. Lifestyle factors: Higher incidence of diabetes, high blood pressure, obesity, drug usage (mainly steroids), consumption of tobacco or alcohol.
  3. Socioeconomic factors: Nutritional deficiencies, frequent child bearing.
  4. Genetic factors: Some families have a genetic predisposition to cataract where the age of onset of cataract is very low.

Upon enquiring about his general health, I found out that he was otherwise healthy and didn’t suffer from any ailments such as diabetes or hypertension. He was also consuming what we consider a balanced healthy diet and didn’t spend much time outdoors under the sun. He neither showed any signs of having a genetic predisposition to cataract.

I realised that none of these factors were present in this young patient suffering from cataract.
Then I asked him if he frequently suffered from a running nose or a cold during seasonal changes in his childhood. I also asked if he had suffered from dermatitis, eczema, itchy skin, asthma or frequently itchy and red eyes.

He replied that during his childhood, he had indeed endured recurring cold and running nose on account of his allergy to pollens. He was also agonised by running nose and stuffy head every time he went to dusty places.

He seemed surprised by the direction my questions were taking: from his eye health to his general health to his past health.

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In my experience, most of the young adults inflicted with cataract have a childhood history of some kind of allergies.

In 2010, we had conducted and published a clinical study on 340 cataract patients in the age group of 30 to 45 years to explore the risk factors for early onset of cataract, in the peer reviewed British Journal, Eye. All these patients had either visited us at our Ahmedabad hospital or at our Out Reach Centre at Dholka. We discovered that some form of allergy was the most prominent common factor among all of them. Furthermore, patients who have had allergic conjunctivitis i.e. watery red itchy eyes, seasonal running nose, asthma, dermatitis in childhood or allergies related to food, drugs etc. are more prone to develop cataract at younger age.

Since then, my focus has been on identifying, studying and conducting research to better understand the reasons associated with cataract among the younger population. I believe that proper knowledge of these factors will help in creating awareness, make people look for the symptoms of early cataract and seek appropriate treatment at the right time.