Cataracts: Symptoms – which complaints can occur and when

Cataracts – also known as 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 harsh and disturbing

The cause lies in the changed scattering of light through the cloudy lens, which scatters light sources uncontrollably and causes so-called halos.

Impaired depth perception

The clouding can disrupt binocular coordination – leading to a deterioration in depth perception.
Steps, curbs or distances become harder to judge.

Possible everyday consequences:

• Unsteady walking on uneven ground
• Tripping, especially in poor lighting
• Uncertainty when parking or overtaking

Depending on the severity and which eye(s) are affected, your sense of space can change noticeably – a clear sign of progressive cataracts.

Double vision in one eye

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

How it shows up:

• Individual letters or objects appear “shifted”
• Double outlines around bright objects or on screens
• Particularly bothersome when reading or during conversations

The cause lies in irregular refractive effects due to the cloudy lens – the image is projected onto the retina multiple times.

Changes in color and contrast perception

As lens clouding increases, colors appear less intense. Blue tones in particular fade – yellow and brown tones dominate the field of vision.

What those affected notice:

• White looks more yellowish
• Blue appears grayer
• Overall, contrasts are weaker

This is because the cloudy lens acts like a yellow filter, distorting the color spectrum and making the visual impression “flatter” – especially noticeable when watching TV or taking photos.

Progression of cataract symptoms: gradual but progressive

Cataracts usually begin unnoticed – and that is exactly what makes them so tricky. The symptoms develop slowly over months or years, making it difficult to recognize the right time for treatment early on.

At first, it’s only small changes:

• Light causes more glare.
• Your glasses “no longer fit as well.”
• Colors look less vivid.

However, as the clouding of the lens of the eye increases, the symptoms become more noticeable – and at some point everyday life can only be managed with difficulty:

• Reading becomes harder, especially in low light
• Driving – especially at night – becomes unsafe
• Faces and contours appear washed out or foggy

Cataracts do not go away on their own. They progress continuously until vision is so impaired that surgery becomes unavoidable. That is why an early diagnosis by an ophthalmologist is crucial to maintain quality of life.

Cataracts or another 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. That is why it is important not to downplay changes in vision, but to have them checked professionally.

Possible mix-ups:

• Macular degeneration: those affected see blurred or distorted vision in the center of their field of view
• Glaucoma: visual field loss occurs – often unnoticed
• Corneal diseases: cause similar light-scattering effects as cataracts
• Refractive changes: nearsightedness or farsightedness that changes with age

Unlike many of these conditions, cataracts can be completely corrected with a relatively minor procedure.
However, this requires a clear diagnosis – ideally through a comprehensive ophthalmological examination with a slit lamp.

When to see a doctor and consider cataract surgery?

At the latest when vision noticeably deteriorates or the symptoms affect everyday life, you should see an ophthalmologist.
Especially with cataracts, the right time for surgery is not strictly defined – what matters is your individual quality of life.

Good times to get it checked:

• When adjustments to your glasses no longer bring improvement
• With increasing sensitivity to glare, e.g. when driving
• When visual acuity noticeably declines in everyday life
• When colors, contrasts or depth perception are impaired

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

How the causes of cataracts are eliminated

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

Cataract surgery procedure:

• 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 provide clear vision, but depending on the lens type can also help correct nearsightedness, farsightedness or presbyopia.

Cataract surgery is now one of the most common and safest surgical procedures worldwide – with excellent prospects of success.