A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope (lens capsule),
varying in degree from slight to complete opacity and obstructing the passage of light. Early in the
development of age-related cataract, the power of the lens may be increased, causing near-sightedness
(myopia), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors.
Cataracts typically progress slowly to cause vision loss, and are potentially blinding if untreated.
The condition usually affects both eyes, but almost always one eye is affected earlier than the other.
A senile cataract, occurring in the elderly, is characterized by an initial opacity in the lens, subsequent
swelling of the lens and final shrinkage with complete loss of transparency. Moreover, with time the
cataract cortex liquefies to form a milky white fluid in a Morgagnian cataract, which can cause severe
inflammation if the lens capsule ruptures and leaks. Untreated, the cataract can cause phacomorphic
glaucoma. Very advanced cataracts with weak zonules are liable to dislocation anteriorly or
posteriorly. Such spontaneous posterior dislocations (akin to the historical surgical procedure of
couching) in ancient times were regarded as a blessing from the heavens, because some perception of
light was restored in the cataractous patients.
Some children develop cataracts, called congenital cataracts, before or just after birth; these
are usually dealt with in a different way to cataracts in adults.
Cataract derives from the Latin cataracta meaning "waterfall" and that from the Greek (kataraktes)
or (katarrhaktes), "down-rushing", from (katarasso) meaning
"to dash down" (from kata-, "down"; arassein, "to strike, dash"). As rapidly running water
turns white, the term may later have been used metaphorically to describe the similar appearance
of mature ocular opacities. In Latin, cataracta had the alternate meaning "portcullis" and it
is possible that the name passed through French to form the English meaning "eye disease" (early 15c.),
on the notion of "obstruction". Early Persian physicians called the term nazul-i-ah, or "descent
of the water" - vulgarised into waterfall disease or cataract - believing such blindness to be caused by
an outpouring of corrupt humour into the eye.
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