Clinical Characteristics of Cataract and Visual Impairment in Working‐Age Adults: A 9‐Year Retrospective Cohort Study
Su Xu, Jingzhi Shao, Jingwen Zhang, Shanshan Du, Kexing Yan, Fengyan Zhang, Yi MaoPurpose
To characterize cataract‐related visual impairment and clinical features in adults aged 18–50 years and to compare unilateral and bilateral cataract cases.
Methods
This single‐center retrospective cohort study reviewed data from patients aged 18–50 years who were diagnosed with cataract between January 2016 and October 2024. Demographic characteristics, systemic and ocular comorbidities, medication history, lifestyle‐related factors, cataract subtype, and ophthalmic examination findings were collected and compared between unilateral and bilateral cases.
Results
A total of 623 patients were included, comprising 272 patients with unilateral cataracts and 351 with bilateral cataracts. The mean age was 40.73 ± 7.55 years, and 278 patients were female. Frequently observed comorbid conditions included hyperlipidemia, high myopia, prior vitrectomy, prior excimer laser surgery, prior trabeculectomy, and uveitis. Posterior subcapsular cataract was the most common subtype in both unilateral and bilateral cases. Compared with bilateral cataract patients, unilateral cataract patients were diagnosed at a younger age, had worse best‐corrected visual acuity (BCVA) at presentation, and had higher rates of prior vitrectomy and uveitis.
Conclusions
Cataract in working‐age adults was frequently accompanied by metabolic and ocular comorbidities. Unilateral cataracts were characterized by younger age at diagnosis and poorer BCVA at presentation. Prior vitrectomy remained associated with unilateral cataract after multivariable adjustment. These findings may help ophthalmologists and clinicians identify younger cataract patients who require closer monitoring and individualized assessment.