Cataracts Pathophysiology Opacification of lens, usually due to age-related pigment build-up. Leads to ↓transparency and ↓refractive index of lens, and hence visual impairment. Causes of premature cataracts Steroids, including topical therapy near eyes. Congenital: trisomy, myotonic dystrophy, infection (rubella, HSV). Ocular disease: glaucoma, severe myopia, retinal detachment. Diabetes UV or infrared radiation. Epidemiology Extremely common: 30% prevalence over age 65, and 60% over 80.