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The lens of an eye is normally clear. If the lens becomes cloudy or is opacified it is called a cataract. Cataracts may rarely be present at or shortly after birth in which case they are called congenital cataracts. Adult cataracts usually develop with advancing age and may run in families. Cataracts are accelerated by environmental factors, such as smoking or other toxic substances. Cataracts may develop at any time throughout life following an eye injury. Cataracts may also develop in response to metabolic diseases such as diabetes. Certain medications, such as cortisone, may accelerate cataract formation.

Congenital cataracts are cataracts which are present from birth (or appear shortly after). They may be familial (autosomal dominant inheritance), or they may be caused by congenital infections such as rubella, or associated with metabolic disorders such as galactosemia. Risk factors include inherited metabolic diseases, a family history of cataract, and maternal viral infection.

Adult cataract is generally associated with aging. It develops slowly and painlessly with a gradual onset of difficulty with vision. Visual problems may include difficulty seeing at night, halos around lights or glare sensitivity, and finally, decreased visual acuity, even in daylight.

Adult cataracts are classified as immature, mature, and hypermature. A lens that has some remaining clear areas is referred to as an immature cataract. A mature cataract is completely opaque. A hypermature cataract has a liquefied surface that leaks through the capsule and may cause inflammation of other structures in the eye.

Most people develop some clouding of the lens after the age of 60. The incidence of visually significant cataract ranges from 50 percent of Americans ages 65 to 74 to about 70 percent of those age 75. Most people with cataract have similar changes in both eyes, although one eye may be worse than the other. Many people with cataract have only minimal visual changes and are not aware of their cataracts. Factors that may contribute to cataract development are low serum calcium levels, diabetes, long-term use of corticosteroids, and various inflammatory and metabolic disorders. Environmental causes include trauma, radiation exposure, and excessive exposure to ultraviolet light (sunlight). In many cases, the cause of cataract is unknown.