Introduction
A cataract is defined as the clouding of the eye lens. As per the present scenario of the world, an immense rise has been seen among the aging population and changing patterns of lifestyle, and innumerable pieces of evidence point towards a potential link that exists between the consumption of alcohol and the development of cataracts, which has contributed significantly to visual impairment worldwide. Alcohol is a widely consumed substance that has been regarded for the generation of reactive oxygen species causing oxidative damage, as the eye lenses remain susceptible to an array of insults and oxidative stress, which could result in cataracts. Thus, a greater understanding is required to understand the complex relationship between the consumption of alcohol and cataracts.
What Is Cataract?
Cataract is a disease of the eye in which the passage of light normally gets obstructed due to opacification of the clear eye lens. The disease progresses gradually and has been a leading cause of blindness worldwide. This type of blindness can affect anyone, ranging from an infant or adult to someone very old. Its occurrence can be bilateral, and the severity can vary. As the disease progresses, daily activities are affected. In the fourth and fifth decades, cataracts eventually mature, interfering with the eye lens and making it opaque to light, thus interfering with daily activities. Many treatment options must be considered for the better, like getting it corrected as soon as possible by using refractive glasses. If it is a case of matured cataract, then surgery is a must.
What Are the Etiological Factors Attributed to Its Occurrence?
Multiple factors have been suggested and involved in the occurrence of cataracts.
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Congenital Cataract: This could have a unilateral or bilateral involvement.
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Traumatic Injuries: Manifesting mostly among young ones, could be anything: blunt trauma, perforating trauma, electric shock, ultraviolet radiation, ionizing radiation, and chemical injuries.
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Systemic Diseases: Myotonic dystrophy, neurofibromatosis type 2, atopic dermatitis.
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Primary Ocular Disease: Chronic anterior uveitis, acute congestive angle closure, high myopia, and hereditary fundus dystrophy.
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Drugs: Corticosteroids and anticholinesterase inhibitors.
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Poor nutrition.
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Alcohol use.
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Smoking.
How Prevalent Is Cataract?
Cataract is regarded to be very common among whites, with a prevalence ranging from 17 to 18 percent per 100 people. Blacks are among the second highest to be affected by it, with a prevalence range of 13 percent. The Hispanics follow this with a range of about 12 percent. Its onset remains gradual and progressive among older people. It is regarded as more common among women than men, with a male-to-female ratio of one to approximately 1.3.
How Does the Formation of Cataracts Take Place?
The eye lens is a transparent structure that is mainly made up of fibers. It is enclosed in a membranous structure known as the capsule of the lens, which consists of older and younger fibers. Many degenerative processes denature and coagulate the lens protein, resulting in a loss of transparency and cataract formation. An opaque lens gets formed due to disturbances occurring at any level of the lens, cortical hydration, and deposition of certain pigmentation, making it difficult for the patient to carry out routine activity.
What Are the Symptoms and Signs of Cataracts?
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Blurring of vision.
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Diplopia and polyopia.
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Colored halos around the eyes.
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Sensitivity to glare.
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Increase in frequency to change the refractive index of glass.
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Disturbance in the color of vision.
Also, during the visual examination, depending on the part of the lens involved, a decrease in visual acuity was noted.
Can Intake of Alcohol Could Be Correlated to Cataract?
Numerous authors have conducted different studies on this burning issue, and there have been conflicting conclusions. It has been found that among regular drinkers, there has been no significantly greater risk of developing cataracts when a comparison was made to that of occasional drinkers, and it has been more suggestive among the current drinkers. Also, it has been quite relative that those who had consumed moderate alcohol, say about 50 percent, had a lesser incidence of cataract surgery than those consuming it heavily. Heavy consumption is more related to the risk of age-related cataracts.
What Does Alcohol Consumption Do?
Oxidative stress contributes to the development of cataracts. When there is a heavy consumption of alcohol, there is a triggering of microsomal enzymes, namely CYP2E1, in the liver. When ethanol metabolizes during that time, this enzyme releases free radicals that aggregate the lens proteins, which do not get metabolized and ultimately lead to cataracts among the elderly. There is yet another reason that has come up: to alcohol, the calcium levels get altered within the lens, and the permeability of the lens fiber cell membrane occurs. Also, a lot is determined by the pattern of alcohol use, frequency of drinking, daily alcohol intake, and the total amount of lifetime drinking, along with the coexistence of comorbidities like hypertension, diabetes, hyperlipidemia, and obesity.
Which Type of Cataract Is Correlated With Increased Alcohol Consumption?
It is an age-related cataract (ARC) and posterior subcapsular cataract (PSC), although it remains largely unexplored. There have been numerous leading studies done in this regard, and an association between age-related macular degeneration and alcohol consumption has been on board. It has been found that a daily intake of alcohol is associated with a modest increase in the risk of PSC cataracts, which actually require an extraction. Thus, there remains a need for further research to establish the actual association between alcohol and cataracts.
What Are the Possible Investigations for Cataracts?
Several investigations have been suggested:
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Checking intraocular pressure.
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Darkroom test.
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Fundoscopy.
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Biometry.
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Peripheral retinal assessment.
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Systemic diseases: Blood glucose, electrocardiography, echocardiography.
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Baseline tests: CBC, liver function test, bleeding profile, hepatitis B testing.
What Are the Treatment Options Available?
It is mainly determined by the degree of opacity which might be sufficient to perform the daily activities. If the visual acuity test is 6/24, then pupillary dilatation is done, and refractive glasses are used. Surgery is opted for when cataracts are adverse and visual acuity falls below 6/24.
Conclusion
An interprofessional team approach must include the primary care providers, specialists, and nursing team. It must be ensured that the patient is educated regarding the steps taken to prevent cataracts. The patients must be advised to wear sunglasses when going out and a face mask or eye goggles when working with anything hazardous. Patients must be advised regarding the adverse effects of alcohol use and consumption.
