Cataracts
Also known as: cataract, age-related cataract, lens opacity, nuclear sclerotic cataract, cortical cataract, posterior subcapsular cataract, congenital cataract, traumatic cataract
A cataract is a clouding of the normally clear crystalline lens of the eye. It may affect one or both eyes and usually develops gradually, causing blurred or hazy vision, glare, halos, reduced contrast, faded colour perception, frequent spectacle-prescription changes and difficulty seeing at night. Cataracts are usually painless. [S1][S2] Age-related change Ultraviolet exposure Diabetes mellitus Smoking Long-term corticosteroid exposure Previous eye injury, inflammation or surgery Radiation exposure Congenital or inherited causes Diagnosis requires an eye examination, usually including visual-acuity testing, slit-lamp examination and assessment of the retina and optic nerve. Reduced vision must not automatically be attributed to cataract because glaucoma, macular degeneration, diabetic retinopathy, retinal detachment and other disorders may coexist. [S1][S3] Cataract surgery, in which the cloudy natural lens is removed and replaced with an intraocular lens, is the only established treatment that removes a cataract. Timing depends on functional impairment, safety, occupational needs, coexisting eye disease and patient preference. [S2][S4] There is no reliable evidence that acupuncture, Chinese herbal medicine, supplements, eye exercises or topical complementary products can dissolve, reverse or remove a cataract. TCM care must therefore be framed only as adjunctive support for general wellbeing or coexisting symptoms and must never delay optometric or ophthalmological assessment or indicated surgery. [S5]
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Lifestyle & Diet
- •Eye care: Arrange regular optometric or ophthalmological review and update spectacles where useful.
- •Eye care: Use adequate lighting, contrast enhancement and glare reduction.
- •Eye care: Avoid driving when vision does not meet legal or personal safety requirements.
- •Eye care: Discuss falls risk, home lighting and mobility support where vision is impaired.
- •Risk reduction: Use sunglasses and a broad-brimmed hat to reduce ultraviolet exposure.
- •Risk reduction: Do not smoke.
- •Risk reduction: Optimise diabetes and cardiovascular risk-factor management.
- •Risk reduction: Use corticosteroids only as prescribed and discuss long-term exposure with the treating clinician.
- •Surgery preparation: Follow the ophthalmologist's instructions regarding medicines, fasting, eye drops and transport.
- •Surgery preparation: Disclose anticoagulants, diabetes medicines, alpha-blockers, allergies and complementary medicines.
- •Surgery preparation: Stop non-essential herbal products before surgery if advised because of bleeding or interaction risks.
- •Postoperative care: Follow prescribed eye-drop and hygiene instructions exactly.
- •Postoperative care: Avoid rubbing the eye, contaminated water exposure and prohibited lifting or exertion during early recovery.
- •Postoperative care: Seek urgent care for severe pain, sudden visual decline, increasing redness, discharge, flashes or new floaters.
Cautions & Contraindications
- •Absolute: No periocular acupuncture in acute eye infection, recent penetrating trauma, orbital cellulitis, uncontrolled bleeding or suspected retinal emergency.[]
- •Absolute: Do not needle through inflamed, infected or damaged skin.
- •Absolute: Do not offer acupuncture or herbs as an alternative to indicated cataract surgery.
- •Relative: Recent cataract surgery requires ophthalmologist clearance before facial or periocular treatment.
- •Relative: Use extra caution with anticoagulants, bleeding disorders, severe myopia, monocular vision, glaucoma and previous retinal surgery.
- •Relative: Avoid strong stimulation of LI4 Hégǔ and SP6 Sānyīnjiāo during pregnancy unless specifically indicated and within scope.
- •Herbal: Review all medicines and planned surgery.
- •Herbal: Avoid herbs that may increase bleeding or alter blood glucose without coordination with the treating team.
- •Herbal: Exclude prohibited, restricted, endangered or undeclared ingredients.
When to reassess or seek care again
- •Visual symptoms should be reviewed by an optometrist or ophthalmologist according to severity. Any adjunctive TCM trial should be brief and reassessed within four to six weeks.
- •Vision worsens
- •Daily function or driving safety is impaired
- •Symptoms are atypical or unilateral
- •Pain or redness develops
- •The patient has not had a recent eye examination
- •Surgery has been recommended or is being considered
Visual acuity and functional vision; Glare and night-driving difficulty; Falls risk; Ability to read, work and perform daily tasks; Progression in one or both eyes; New pain, redness, flashes, floaters or field loss
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Sources & Further Reading
Clinical guidance, red flags and safety notes on this page draw on the following current sources alongside the classical references above.
Educational reference for licensed practitioners. Not a substitute for individual clinical assessment. Refer to conventional care for any red-flag or undiagnosed presentation.