What Is Nuclear Sclerosis?

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Nuclear sclerosis is a primarily age-related eye condition in which the central part of the lens hardens or gets cloudy. As this part of your eye—also called the nucleus—is what receives light, nuclear sclerosis can greatly impact your vision. Lenses affected by nuclear sclerosis can also become noticeably cloudy or yellow.

The condition is called nuclear sclerotic cataracts when it progresses to the point that it is severe or causes symptoms.

This article reviews the symptoms of nuclear sclerotic cataracts, causes and risk factors, and how they're diagnosed and treated.

nuclear sclerosis symptoms
Illustration by Emily Roberts, Verywell

Nuclear Sclerosis Symptoms

Early on, symptoms of nuclear sclerosis can be subtle. It may take a long time for you to notice them.

They can include:

  • Worsening vision (especially distance) that doesn't improve with glasses or contacts
  • Needing frequent updates to your lens prescription
  • Blurry, unfocused vision ("clouding")
  • Colors and shadows appearing less vivid
  • "Haloes" or rings around light sources; seeing a glare
  • Trouble seeing at night, especially when driving

Some people with nuclear sclerosis see a temporary improvement in their vision. This is sometimes called second sight. It can make you think your eyes have gotten better. However, the slow decline inevitably continues.

You may eventually notice a change in your eye's appearance (cloudiness, yellowing, browning), though someone close to you may notice it first. A doctor may also discover it during a physical or eye exam.

At first, you may get a cataract in just one eye. Over time, you'll likely develop one in the other eye, too.

A nuclear sclerotic cataract can be classified as either immature or mature, depending on how severe the clouding is. In severe cases, untreated nuclear sclerotics cataracts can cause blindness.

Cataracts are the leading cause of blindness both in the United States and around the world.

Recap

In nuclear sclerotic cataracts, the center of the eye's lens becomes thick and discolored. This clouds your vision. Blurred vision, haloes around lights, and washed-out colors are common symptoms. Vision may improve, only to decline again. Severe cases can lead to blindness.

Causes

If you live long enough, you're almost certain to develop an age-related cataract—and nuclear sclerotic cataracts are the most common kind.

Proteins in your lens naturally break down over time. They clump together, in this case, causing hardening that impedes light from passing through the center of the lens to the retina.

The retina processes light and transfers signals that allow your brain to register images. Less light going through the center of the lens due to nuclear sclerosis means less "information" for the retina to translate. That, in turn, equates to vision issues.

Other types of cataracts result from changes to different parts of the lens.

What Is a Nuclear Senile Cataract?

Any cataract caused by aging (rather than trauma or disease) can be classified as a senile cataract. Nuclear senile cataract simply means that the cataract is age-related and in the center of the eye's lens.

Risk Factors

Age is the main risk factor for nuclear sclerotic cataracts. Other risk factors include:

Having a relative who had cataracts early in life may mean early cataracts for you as well.

Recap

Aging is the most common cause of nuclear sclerotic cataracts, but some modifiable factors like smoking, heavy alcohol use, and exposure to UV light can increase your risk.

Diagnosis

If you have symptoms that could point to nuclear sclerosis, see an eye doctor (ophthalmologist).

Nuclear sclerotic cataracts are typically easy to diagnose. That's especially true if they've changed how the lens looks.

Doctors use special eye drops to dilate (widen) your pupil. Then they look inside your eye with a handheld instrument called an ophthalmoscope and a slit-lamp microscope. If you have nuclear sclerosis, the doctor will see abnormalities in the lens's nucleus.

They'll also perform refraction (vision prescription) and acuity (eye chart) tests on both eyes to check your vision's clarity and sharpness.

Sometimes an eye doctor can see early changes before you have noticeable symptoms. This reinforces the importance of routine eye exams: Early diagnosis means early treatment, and that may prevent or delay serious vision loss—including blindness.

Treatment

Everyone with nuclear sclerotic cataracts has a different experience. Some people aren't bothered by them, while others' vision is severely affected. Treatment can help preserve your vision.

Treatments for nuclear sclerotic cataracts are the same as for all types of cataracts. You have several options, which you and your doctor will consider depending on the severity of your condition and the extent to which it is impacting your life.

Managing Symptoms

Early on, glasses or contacts may be all you need. You may also find it helpful to:

  • Use brighter lightbulbs
  • Wear anti-glare sunglasses
  • Use a magnifying lens for reading and close-up activities

Eventually, doctors may be able to treat nuclear sclerosis with eye drops. Treating it in the early stages may prevent NS cataracts from forming. For now, though, this treatment is experimental.

Surgery

Doctors generally suggest surgery when cataracts of any type significantly impact your life or make you unable to drive.

Cataract surgery involves removing the cloudy lens and replacing it with a clear synthetic one that is created especially for your eye. It is considered safe for most people.

If you have nuclear sclerotic cataracts in both eyes, they will probably be removed during separate procedures done about a week apart. Most people fully recover in about eight weeks.

Recap

An eye doctor can identify nuclear sclerosis with tests you should already be familiar with if you've had a routine eye exam. Glasses may be all you need in the beginning, but surgery to replace your lens may be recommended later on.

Summary

Nuclear sclerotic cataracts impact the center of your eye's lens. With age (or sometimes, eye disease), the lens thickens, becomes cloudy, and impairs your vision.

Symptoms include blurry vision (especially at night), frequent updates to your corrective lenses, and colors appearing less vivid.

Doctors diagnose nuclear sclerosis with a dilated eye exam. Treatment includes corrective lenses or, later on, surgery to replace the affected lens.

A Word From Verywell

With treatment, nuclear sclerosis and nuclear sclerotic cataracts rarely cause blindness. Getting regular eye exams is key to early diagnosis and treatment, which can help preserve your vision.

Remember that you may not notice growing nuclear sclerotic cataracts for years. As you get older, don't skip these exams and tell your doctor about any vision changes.

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  1. University of Michigan Health System, Kellogg Eye Center. Nuclear cataract. Updated March 2015.

  2. American Optometric Association. Cataract.

  3. Frampton G, Harris P, Cooper K, et al. Chapter 1: Background. In: The clinical effectiveness and cost-effectiveness of second-eye cataract surgery: a systematic review and economic evaluationSouthampton (UK): NIHR Journals Library; 2014.

  4. U.S. Centers for Disease Control and Prevention. Common eye disorders and diseases. Updated June 3, 2020.

  5. Yanoff M, Sassani JW. Chapter 10 - Lens. In: Ocular pathologyElsevier; 2020:380-406.

  6. National Institutes of Health, National Eye Institute. Cataracts. Updated August 3, 2019.

  7. Ang MJ, Afshari NA. Cataract and systemic disease: A reviewClin Exp Ophthalmol. 2021;49(2):118-127. doi:10.1111/ceo.13892

  8. American Academy of Ophthalmology: EyeSmart. What are cataracts? Updated July 7, 2021.

  9. Sanchez RF, Everson R, Hedley J, et al. Rabbits with naturally occurring cataracts referred for phacoemulsification and intraocular lens implantation: a preliminary study of 12 cases. Vet Ophthalmol. 2018;21(4):399-412. doi:10.1111/vop.12525

  10. Thompson J, Lakhani N. Cataracts. Prim Care. 2015;42(3):409-23. doi:10.1016/j.pop.2015.05.012