1. It is important to note the difference between physiological aging of the crystal and senile cataract The normal crystal is located in the anterior segment of the eye and is transparent; if it becomes cloudy and opaque, it indicates a cataract. It most commonly occurs after the age of 50 and is mostly a senile cataract, the occurrence and progression of which increases with age. There is also a situation in which the water contained in the crystal gradually decreases with age and its central core gradually hardens, which, together with the increase in metabolites of crystal proteins, causes the lens to look yellowish and seem opaque. It is essential to note the distinction between the two. Every patient should have their vision checked, and if the vision is normal (including corrected vision that can meet normal standards), the first consideration should be physiological aging of the lens. Checking whether the crystal is cloudy should be done by slit lamp microscopy and, if necessary, dilating the pupil (it is better to measure the intraocular pressure before examination).
2. Pay attention to other eye diseases that affect vision with cataract In elderly people, there are various eye diseases that affect vision, especially some eye diseases with slow onset and inconspicuous symptoms, which are easy to be overlooked and missed if they exist together with cataract. Therefore, for patients found to have senile cataracts, it is important to pay attention to whether the intraocular pressure is normal or not. It is best to measure the intraocular pressure and check the optic nerve in the fundus for any glaucoma-like changes. These tests should be followed up regularly. If glaucoma is present, the glaucoma should be treated aggressively. In addition, the elderly can also have diseases that affect the retina such as hypertension, atherosclerosis and diabetes, as well as diseases of the eye itself such as age-related macular degeneration, all of which affect vision and should be treated aggressively.