Understanding the Four Stages of Cataracts Progression

Learn about the stages of cataracts, their symptoms, treatment options, and how they impact vision at every step.

By Sneha Tete, Integrated MA, Certified Relationship Coach

Created on Sep 25, 2025

Learn about the stages of cataracts, their symptoms, treatment options, and how they impact vision at every step.

What Are Cataracts?

Cataracts are a common eye condition where the normally clear lens of the eye becomes cloudy, interfering with light transmission to the retina. This clouding leads to a gradual decline in vision and, if left untreated, can eventually cause significant vision loss. While cataracts most often affect older adults, they can occur at any age or even at birth due to various risk factors and causes.

Prevalence: Cataracts remain a leading cause of visual impairment globally, especially among individuals over age 50.
Symptoms: Early symptoms typically include blurred vision, increased sensitivity to light, glare, duller color perception, and trouble seeing at night.
Causes: Aging, genetic factors, diabetes, trauma, medications, and other medical conditions can lead to cataract formation.

The progression of cataracts is typically slow and can impact everyday activities such as driving, reading, or recognizing faces. Early identification and management are key to preserving vision and maintaining quality of life.

How Are Cataracts Staged?

The staging of cataracts helps healthcare professionals, especially eye doctors and surgeons, gauge the severity of the condition and determine the most suitable time and type of treatment. Although these stages are more commonly used in research and clinical decision-making rather than in routine patient appointments, understanding them can help individuals track their symptoms and seek timely care.

Purpose of Staging: Staging standardizes descriptions of the disease’s progression and aids in insurance eligibility for surgery.
Types vs. Stages: While type of cataract affects symptoms and treatment decisions, stage primarily describes the degree of lens cloudiness and related vision impairment.

Regardless of the cataract’s origin, most progress through the four main stages: early, immature, mature, and hypermature. Each stage is associated with characteristic symptoms and varying impacts on daily life.

Early Stage Cataracts

Early cataracts are marked by the initial formation of small, cloudy areas in the lens. This stage is often subtle, with many people experiencing no significant change in vision. Early cataracts are more common in younger individuals compared to later stages.

Slightly blurred or cloudy vision: Visual acuity may remain largely intact, with only mild changes noticed.
Increased sensitivity to light and glare: Bright sunlight or headlights at night may seem harsh.
Frequent eyestrain: Activities requiring focus, like reading, might fatigue the eyes more quickly.
Subtle color changes: Colors may appear less vibrant or slightly muted.

Because symptoms are mild, people might attribute them to other causes or ignore them altogether. Eye examinations remain critical for early identification.

Immature Cataracts

In the immature stage, the lens shows increased cloudiness, but some clear areas remain. This allows light to continue passing through to the retina, though visual disturbances are often more noticeable than before.

More pronounced blurriness: Objects may appear hazy, especially in low lighting or at night.
Difficulty seeing in low light: Night driving or reading under dim lighting becomes challenging.
Increased glare and halos: Bright lights may produce distracting rings or halos.
Faded or duller colors: Color perception diminishes further, and contrast is reduced.

This stage can disrupt daily activities, making tasks like reading, sewing, or driving more difficult. However, complete vision loss has not yet occurred.

Mature Cataracts

Mature cataracts refer to the point where the entire lens has become densely clouded and opaque, significantly impairing vision. By this stage, cataracts have typically been present for several years and cause obvious visual disability.

Significant vision loss: Vision becomes extremely blurry or foggy, often compromising the ability to navigate safely.
Severe difficulty with daily activities: Activities such as reading, recognizing faces, and driving are often no longer possible.
Double vision in one eye: Some may notice “ghosting” or multiple images.
Intense halos around lights: Street lights and headlights may seem surrounded by rings or bursts, especially at night.

The stage typically necessitates professional intervention, as vision loss is severe and affects independence and safety.

Hypermature Cataracts

The hypermature stage is the most advanced form of cataract. Here, the lens material continues to deteriorate. The lens may shrink, harden, and even leak proteins into the eye, potentially causing inflammation or increased eye pressure.

Completely white, pearly, or milky lens appearance: The lens is often visibly clouded, and visible even without special instruments.
Profound vision loss: The ability to see is typically limited to detecting motion or counting fingers held close to the face.
Severely increased eye pressure: This can lead to secondary complications.
Lens dislocation: The lens can shift from its normal position, sometimes causing irritation or pain.

This stage is associated with heightened risk of complications such as phacolytic glaucoma and uveitis (eye inflammation). Emergency treatment may be necessary to prevent permanent vision damage or pain.

Types of Cataracts

While all cataracts progress through the four major stages, types of cataracts can differ based on where or how the lens becomes clouded.

Type	Description
Nuclear	Forms in the center (nucleus) of the lens, often leading to gradual yellowing or browning.
Cortical	Wedge-shaped opacities develop around the lens edges (cortex) and may slowly extend inwards.
Posterior Subcapsular	Occurs at the back of the lens, often progressing more quickly and affecting vision, especially in bright environments.
Congenital	Present at birth or developing in early childhood, often due to genetics or infection.
Secondary	Develops as a result of other medical conditions (such as diabetes), medications (notably steroids), or after eye surgery.
Traumatic	Results from direct injury to the eye, often appearing years after the initial trauma.
Radiation	Occurs following exposure to certain forms of radiation, such as after cancer treatment involving the head or neck.

The type of cataract impacts both the pattern of progression and the specific symptoms experienced.

Risk Factors for Cataracts

Age: Most common in people over 50, but can occur at any age.
Diabetes: Increases risk and rate of cataract development.
Family history: Genetics can play an influential role.
Excess sun exposure: UV radiation accelerates lens changes.
Heavy alcohol use, smoking, and obesity each contribute to risk.
High blood pressure and previous eye injuries are associated with earlier onset.
Radiation therapy: Increases likelihood, especially after head/neck radiation for cancer treatment.

Some medications (particularly corticosteroids like prednisone) are also linked to cataract formation. Protective measures such as wearing sunglasses and managing underlying diseases may help slow the process.

Cataract Treatment by Stage

Treatment for cataracts is dictated by stage and functional impact on vision. Early stages might only require visual aids, while advanced stages nearly always require surgical intervention.

Early Stage: Stronger glasses, improved lighting, and anti-glare lenses may help maintain vision.
Immature to Mature Stages: When symptoms worsen and everyday activities suffer, surgery to remove and replace the clouded lens becomes the best option.
Hypermature Stage: Prompt surgery may be necessary to reduce the risk of complications such as inflammation, high eye pressure, or lens dislocation.

Cataract surgery is one of the safest and most effective procedures performed worldwide, with high success rates in restoring vision. During surgery, the cloudy lens is removed and replaced with a clear artificial lens called an intraocular lens (IOL).

Frequently Asked Questions (FAQ) about Cataract Stages

How fast do cataracts progress?

The speed of cataract progression varies. Most age-related cataracts worsen slowly over years, while those caused by diabetes, trauma, or radiation may progress more rapidly.

Can cataracts be reversed?

Cataracts cannot be reversed with medication or home remedies. While some methods may slow development (such as managing underlying medical conditions and protecting eyes from UV light), surgery is the only definitive treatment for restoring vision.

At what stage should cataracts be removed?

Removal is generally recommended when cataracts interfere with daily life, affecting activities such as reading, driving, or watching TV. Surgery may be urgent if complications arise, as in the hypermature stage.

How long does it take to go blind from cataracts?

This depends on the cause and individual factors. Age-related cataracts may take many years to cause significant blindness, while traumatic or congenital cataracts can result in rapid vision loss under certain circumstances.

Summary

Cataracts develop gradually but predictably, moving from early to hypermature stages. Symptoms intensify as the lens becomes more clouded, making prompt identification and timely intervention essential. Key takeaways include:

Cataracts are progressive but highly treatable.
Symptoms and vision loss worsen over time, often requiring different interventions at different stages.
Surgical treatment offers a high success rate for restoring functional vision.
Regular eye exams are critical for early detection and management.

If you suspect you are developing cataracts or notice changes in vision, consult an eye care professional for an accurate diagnosis and personalized treatment plan.

References

Author

Sneha TeteBeauty & Lifestyle Writer

Sneha is a relationships and lifestyle writer with a strong foundation in applied linguistics and certified training in relationship coaching. She brings over five years of writing experience to thebridalbox, crafting thoughtful, research-driven content that empowers readers to build healthier relationships, boost emotional well-being, and embrace holistic living.

Read full bio of Sneha Tete