Think cataracts only happen after 60? Doctor warns that diabetes is making this eye condition appear decades earlier

For decades, cataracts were considered a natural part of ageing. Most people expected to hear about them after retirement, not while building careers or raising young families. But eye specialists are now noticing something that would have seemed unusual a generation ago. More adults in their 30s and 40s are being diagnosed with cataracts.

While getting older remains the biggest risk factor, doctors say changing lifestyles and the growing burden of diabetes are shifting the timeline. India is home to one of the largest populations of people living with diabetes, making this trend especially concerning.

Experts say cataracts do not appear overnight. They develop gradually, often without causing pain. That is why understanding the link between diabetes and eye health can make a real difference.

Dr Aravind Badiger, Technical Director, BDR Pharmaceuticals International Pvt. Ltd., said, "Cataracts have generally been seen in elderly people, but we are now witnessing that the same is appearing even in individuals in their 30s and 40s. Ageing is still the primary factor; the increased incidence of diabetes, obesity, and unhealthy lifestyles is responsible for cataracts developing at an early age. The increasing number of cases of diabetes in India makes it crucial to understand the link between high blood glucose and eyes."

Several factors may contribute to early cataracts. Smoking, obesity, poor nutrition, long-term steroid use, excessive exposure to ultraviolet (UV) rays and certain metabolic disorders all increase the risk. However, among these, diabetes stands out because of the way it directly affects the eye's natural lens.

This is one reason doctors now encourage people with diabetes to think about eye health long before vision starts becoming blurry.

The connection between diabetes and cataracts is not just a statistical one. It is based on what happens inside the eye when blood sugar remains high for long periods.

Dr Badiger explained, "The eye lens has high sensitivity to blood glucose levels. In the case where glucose levels in the blood stay high for a long time, extra glucose in the blood gets into the eye lens and is turned into sorbitol via the polyol pathway. The sorbitol is retained in large amounts because it exits the lens slowly and causes fluid retention in the lens."

He added, "Besides, the presence of continuous hyperglycaemia leads to oxidative stress and damage to the lens proteins, causing them to clump together. Over time, this makes the originally clear lens become opaque, resulting in cataracts."

In simple words, persistently high blood sugar changes the chemistry inside the eye. The lens, which should stay clear to focus light, gradually becomes cloudy. As that cloudiness increases, vision becomes less sharp.

One of the biggest challenges with cataracts is that they usually develop slowly. Many people assume they simply need a stronger pair of glasses or that tired eyes are to blame.

According to Dr Badiger, these symptoms should never be ignored:

Cloudy or blurred vision
Increased sensitivity to bright lights
Difficulty seeing at night
Colours appearing dull or faded
Frequently needing a new spectacle prescription
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These symptoms do not always mean cataracts, but they are strong enough reasons to schedule an eye examination.

Not every cataract can be prevented because ageing itself changes the eye over time. But experts say lifestyle choices can influence when those changes begin.

Dr Badiger recommends keeping diabetes under good control through medication, healthy eating and regular monitoring of blood sugar levels.

He also advised maintaining healthy blood pressure and cholesterol because they support overall eye health.

People living with diabetes should have a comprehensive eye examination every year, even if they feel their vision is normal. Regular check-ups allow doctors to detect changes before they become severe.

A balanced diet rich in leafy vegetables, colourful fruits and antioxidant-containing foods may also support long-term eye health. Avoiding smoking, limiting alcohol intake and wearing sunglasses that block ultraviolet rays while outdoors are additional steps that may help reduce risk.

Many people think diabetes mainly affects the heart, kidneys or nerves. The eyes are often forgotten until vision begins to change.

That can be a costly mistake.

A cataract caught early is easier to manage, and controlling blood sugar may help delay damage to the lens. Waiting until vision becomes severely blurred may mean living with unnecessary vision loss that could have been detected sooner.

This article includes expert inputs shared with TOI Health by:

Dr Aravind Badiger, Technical Director, BDR Pharmaceuticals International Pvt. Ltd.

Inputs were used to explain why cataracts are increasingly affecting younger adults, how diabetes accelerates the condition, and the steps people can take to protect their vision.