Cataract symptoms: What symptoms can occur and when

Cataracts are one of the most common eye diseases in older people. However, many of those affected hardly notice the changes at first, because: The symptoms develop gradually. It is only gradually that vision becomes cloudy, colors fade and everyday situations such as reading, driving or climbing stairs become a challenge.

In this article you will learn:

• Which symptoms are typical for cataracts
• How you can recognize the first signs early on
• When an intervention makes sense – and how it works

The earlier cataracts are diagnosed, the better the results of the treatment.

Typical symptoms of cataracts at a glance

Depending on the stage, progression and personal perception, the symptoms of cataracts can be more or less intense in some people. As a rule, the clouding of the lens of the eye manifests itself through several of these symptoms:

Loss of visual acuity

One of the most common and first signs of cataracts is the gradual deterioration of visual acuity.
The image becomes increasingly blurred – as if you were looking through slightly fogged glasses. This is particularly noticeable when reading or recognizing faces and details in the distance.

Typical everyday situations:

• Small print is becoming more difficult to decipher – despite reading glasses
• Street signs or house numbers appear blurred
• The TV suddenly appears “out of focus”

The cause: the cloudy lens lets less light through – the image sharpness on the retina decreases.

Sensitivity to glare from the sun and other light sources

Many patients report increasing sensitivity to light and glare – especially in direct sunlight, car headlights or reflective surfaces.

Typical complaints:

• Sunglasses suddenly become mandatory – even on cloudy days
• Driving at night becomes unpleasant or even dangerous
• Artificial light (e.g. in the supermarket) is perceived as glaring and disturbing

This is due to the altered light scattering caused by the cloudy lens, which scatters light sources in an uncontrolled manner and causes so-called halos.

Limited spatial vision

The clouding can disrupt binocular interaction, which leads to a deterioration in spatial vision.
Steps, kerbs or distances are more difficult to judge.

Possible consequences in everyday life:

• Unsafe walking on uneven ground
• Stumbling, especially in poor lighting
• Uncertainty when parking or overtaking

Depending on the severity and the eyes affected, the sense of space can change significantly – a clear indication of the progression of the cataract.

Double vision in one eye

A rather rarer but characteristic symptom is double vision, which is only perceived in one eye – also known as monocular diplopia.

How this manifests itself:

• Individual letters or objects appear “shifted”
• Double contours with bright objects or on screens
• Particularly distracting when reading or during conversations

This is caused by irregular refractive effects due to the cloudy lens – the image is projected onto the retina several times.

Change in color and contrast perception

Colors appear less intense with increasing lens opacity. Blue tones in particular fade – yellow and brown tones dominate the field of vision.

What those affected notice:

• White appears rather yellowish
• Blue appears grayer
• Contrasts are weaker overall

This is because the cloudy lens acts like a yellow filter that distorts the color spectrum and makes the visual impression appear “flatter” – particularly noticeable when watching television or taking photographs.

Progression of cataract symptoms: gradual but progressive

Cataracts usually begin unnoticed – and that is precisely what makes them so insidious. The symptoms develop slowly over months or years, which makes it difficult to recognize the right time for treatment at an early stage.

Initially, these are only small changes:

• The light is more dazzling.
• The glasses “no longer fit so well”.
• Colors appear less vivid.

However, as the clouding of the lens of the eye increases, the symptoms become more pronounced – and at some point it becomes difficult to cope with everyday life:

• Reading is more difficult, especially in low light
• Driving – especially at night – is becoming unsafe
• Faces and contours appear washed out or foggy

Cataracts do not disappear by themselves. It progresses continuously until vision is impaired to such an extent that an operation becomes unavoidable. Early diagnosis by an ophthalmologist is therefore crucial in order to maintain quality of life.

Cataract or other eye disease? Differentiation from other causes

Many of the typical symptoms of cataracts – such as blurred vision, sensitivity to glare or double vision – can also occur with other eye diseases. It is therefore important not to trivialize changes in vision, but to have them professionally clarified.

Possible confusion:

• Macular degeneration: Affected people have blurred or distorted vision in the center of the field of vision
• Glaucoma: Visual field defects occur – often unnoticed
• Corneal diseases: cause similar light scattering effects to cataracts
• Refractive changes: Myopia or hyperopia that changes with age

Unlike many of these diseases, cataracts can be completely cured with a comparatively minor procedure.
However, this requires a clear diagnosis – preferably by means of a comprehensive ophthalmological examination with a slit lamp.

When should I see a doctor and consider cataract surgery?

A visit to the ophthalmologist should be made at the latest when vision deteriorates noticeably or the symptoms interfere with everyday life.
The right time for an operation is not strictly defined for cataracts in particular – the individual quality of life is decisive.

Sensible times for clarification:

• When spectacle adjustments no longer bring any improvement
• With increasing sensitivity to glare, e.g. when driving a car
• When visual acuity decreases noticeably in everyday life
• If colors, contrasts or spatial vision are limited

Even if the symptoms are only mild: Early diagnosis ensures optimal results – especially for active people who want high visual performance.

How to eliminate the causes of cataracts

Cataracts are caused by a progressive clouding of the natural lens of the eye – and cannot be stopped with medication or drops.
The only effective treatment is surgical removal of the cloudy lens and replacement with an artificial intraocular lens (IOL).

Procedure for cataract surgery:

• Minimally invasive procedure, usually outpatient
• The cloudy lens is removed by phacoemulsification
• A clear artificial lens is inserted into the empty lens capsule
• Duration: approx. 15-20 minutes per eye

Modern intraocular lenses not only offer clear vision, but can also correct short-sightedness, long-sightedness or presbyopia, depending on the type of lens.

Cataract surgery is one of the most common and safest surgical procedures in the world today – with excellent prospects of success.