From Younger Eyes To Ageing Vision, The Cataract Challenge Grows

Cataract, traditionally considered an age-related eye condition, is increasingly being reported among younger adults, with doctors pointing to diabetes, prolonged steroid exposure and other medical and lifestyle factors that may cause the eye's natural lens to become cloudy earlier than expected.

Certain genetic conditions and metabolic disorders, including galactosaemia and abnormalities in calcium levels, can also cause premature cataract formation, say the doctors.

Diabetes is among the important risk factors. Persistently high blood glucose can alter the proteins in the eye's natural lens, causing it to lose transparency. With diabetes increasingly affecting younger adults in India, this could have implications for the age at which cataracts develop.

Also, prolonged exposure to corticosteroids, particularly oral medicines and steroid-containing eye drops, can cause posterior subcapsular cataract, a type that may interfere with vision relatively early. Smoking and excessive exposure to ultraviolet radiation can also contribute to lens damage.

Doctors caution that blurred vision, difficulty reading, glare while driving at night and frequent changes in spectacle power should not be dismissed as routine eyesight problems, particularly among younger adults. An eye examination can help identify cataracts and other underlying conditions.

Although genetic predisposition cannot be modified, better control of diabetes, avoiding unnecessary steroid use, quitting smoking and protecting the eyes from excessive ultraviolet exposure may help reduce some avoidable risks.

A study published in the Indian Journal of Ophthalmology in May 2026, titled Decoding the rising trend of presenile cataracts in the post-COVID era – Indian scenario, examined 52 patients aged 18-50 years who presented with visually disabling cataracts at a tertiary-care hospital in north India.

Conducted by Dr Parul Bansal, Dr Amit Mehtani and Dr Chirag Kalra of the Department of Ophthalmology, Deen Dayal Upadhyaya Hospital, New Delhi, the study found that 51.9% of patients had no identifiable conventional risk factors. The mean age was 39.6 years, and women accounted for 57.7% of the cases.

Posterior subcapsular cataract was the most common type, accounting for 32.7% of cases, followed by combined nuclear-cortical cataract at 28.8%.

Nearly one-fourth (23.1%) of the participants reported a previous Covid-19 infection. However, the study did not establish a causal link between Covid-19 and early cataract formation. The authors called for further research to investigate the possible association.

Dr Sanjay Dhawan, CEO and Director, Medical Services, Indira Gandhi Eye Hospital and Research Centre, said, “It's my personal observation that senile cataract is now occurring at an earlier age, especially after the COVID pandemic - regardless of whether a person has COVID or had taken steroids.”

Another Indian study published in the journal Eye examined lens opacities among people in their early 40s. The population-based research, involving 1,080 participants aged 41-44 years from the Vellore Birth Cohort in Tamil Nadu, found that 13.8% had cataracts or lens opacities. Diabetes, hypertension and other health conditions emerged as potential risk factors.

While early-onset cataract is drawing attention, the larger burden of the condition continues to fall on older adults. Timely surgery can restore sight; however, the challenge extends beyond increasing the number of operations to ensuring that patients regain good functional vision.

A population-based study in West Bengal has highlighted this gap. Published in Discover Public Health in October 2026, the study, titled Cataract surgical coverage effectiveness and barriers to cataract surgery in a population-based eye health survey in Jhargram district, West Bengal, examined 2,292 adults aged 40 and above across 48 villages.

Researchers Dr Ananta Basudev Sahu, Dr Jhumki Kundu, Dr Sudipta Mohanty and Dr RN Mohanty of Sightsavers India, New Delhi, found that among 291 people who had undergone cataract surgery, 57.7% had very good vision in the operated eye, while 19.9% had good vision. However, 13.4% had suboptimal outcomes and 8.9% continued to have poor vision.

Surgical or postoperative complications accounted for 61.5% of cases with poor visual outcomes, while residual refractive errors were the leading reason for borderline outcomes, accounting for 59% of such cases.

The study also found a gender gap in access to treatment. Among people aged 50 and above, cataract surgical coverage at the blindness threshold was 86.9% among men, compared with 68% among women.

Lack of perceived need was the most commonly reported reason for not undergoing surgery, cited by 43.5% of those who had not received treatment. Another 24.7% feared the procedure or a poor outcome. Limited access and financial constraints were also reported.

“Vision impairment is more than just difficulty in seeing. It affects social, physical and mental health, as well as overall well-being,” said Dr Srinivas Marmamula, DBT-Wellcome Trust Clinical and Public Health Intermediate Fellow at the LV Prasad Eye Institute, Hyderabad, while discussing the institute's Longitudinal Eye Health, Ageing and Disability Study.

The study examines how vision loss affects falls, depression, cognitive decline and independence among older adults in Andhra Pradesh and Telangana. It also assesses whether interventions such as cataract surgery and corrective spectacles can improve their health and well-being.

Globally, cataracts affect more than 94 million people.

Over the past two decades, global cataract surgical coverage has increased by about 15%, even as ageing populations and rising cataract cases have added to demand. Latest modelling projects an increase of about 8.4% in coverage during the current decade. However, progress needs to accelerate to meet the World Health Assembly target of a 30% increase by 2030.

Recognising the growing need for cataract surgery and specialised eye-care services as India's population ages, Dr Shuchin Bajaj, CEO of Ujala Cygnus Hospital Group, said he plans to make a significant entry into the eye-care sector focussing on cataract surgery among elder people.

“We should not just count the number of operations performed but also pay adequate attention to how well patients can see afterwards,” he said.

With children increasingly living and working away from their parents, many elderly people have to manage daily activities with limited support, Dr Bajaj said, adding that “restoring their vision can help them remain active and independent for longer.”

He also pointed to the wider impact of vision restoration on families, particularly the role grandparents play in caring for grandchildren, supporting their education and contributing to household responsibilities.

“When we restore a grandparent's vision, we are not just helping one person see again. We are helping an older generation retain its independence and continue contributing to the lives of those who come after them. That is the wider social return on investing in quality eye care,” he said matter-of-factly.

“Cataract surgery is one of the most powerful tools we have to restore vision and transform lives,” added Devora Kestel, Director of AI, WHO Department of Noncommunicable Diseases and Mental Health. “When people regain their sight, they regain independence, dignity, and opportunity.”