Incipient cataract symptoms and treatment: everything you need to know as a cataract sufferer

The onset of cataracts often goes unnoticed. The clouding of the lens of the eye develops gradually, and initial symptoms such as blurred vision, sensitivity to glare or a gray haze are often dismissed as normal signs of ageing. However, so-called senile cataract – an age-related eye disease – can be treated well if it is detected early.

In this blog you will learn:

• What signs indicate the onset of a cataract
• How the diagnosis is made by the ophthalmologist
• When cataract surgery is recommended – and when you can wait and see
• What treatment options are available today – including modern laser procedures and artificial lenses
• And what you can do to prevent clouding of the lens for as long as possible

If you deal with the issue of cataracts at an early stage, you can better assess the right time for treatment – and preserve your own vision in the long term.

Interpreting the first signs correctly: Suspicion of cataracts?

When your vision slowly changes, it often seems harmless at first: you reach for your glasses more often, find bright light unpleasant or struggle to see clearly in the dark. However, these gradual changes can conceal the onset of cataracts. Around 90 % of people over the age of 65 are affected by cataracts in the course of their lives. This makes it all the more important to recognize the first symptoms and act in good time.

Typical symptoms that indicate the onset of a cataract

The onset of cataracts is often indicated by subtle changes in vision. Typical signs are

• Blurred or “milky” vision
• Increased sensitivity to glare, e.g. in the sun or when driving at night
• More frequent change of glasses without real improvement in vision
• Color changes, especially paler or yellowish color perception
• Difficulty reading despite good lighting
• Double vision in one eye

Why cataracts often start unnoticed

The clouding of the lens in cataracts develops gradually. Unlike acute eye diseases such as glaucoma, cataracts do not cause any pain – and visual performance decreases so gradually that the change is often only noticed late.

Particularly insidious: those affected unconsciously get used to their “new vision”. Only when the clouded lens significantly reduces visual acuity or impairs activities such as reading, watching TV or driving is the eye specialist consulted – often later than would be ideal.

Therefore, anyone who notices one or more of the symptoms mentioned above should have cataracts diagnosed at an early stage. A targeted examination will quickly provide clarity – and open up the possibility of starting appropriate treatment in good time.

What happens in the eye with cataract symptoms

Cataracts cause a slow clouding of the lens of the eye – a clear, elastic structure directly behind the pupil. The lens structure changes as a result of the natural ageing process, but also due to factors such as diabetes, UV radiation or certain medications: protein molecules clump together and the lens loses its transparency – it becomes cloudy.

This clouding allows less light to pass through to the retina and affects the quality of vision: contrasts fade, colors appear duller and seeing against the light becomes more difficult. In the early stages, this is hardly noticeable – but if left untreated, the clouding of the lens can permanently impair vision or even lead to blindness.

When should you see an ophthalmologist?

Cataracts develop slowly – but the earlier they are detected, the easier and more successful the treatment will be. A visit to the ophthalmologist is particularly advisable if the visual acuity changes, the image appears blurred or there is sensitivity to glare. Even if new glasses no longer bring any improvement, this may be an indication that the lens is beginning to cloud.

Early detection is crucial – not only to preserve vision, but also to initiate appropriate treatment in good time.

What happens for cataracts to be diagnosed

If cataracts are suspected, the ophthalmologist will carry out a targeted examination. This includes

• Visual acuity test: Determines whether visual performance has decreased
• Slit lamp examination: The lens of the eye is viewed directly with a special microscope – early opacities can be detected in this way
• Examination of the retina: To rule out other eye diseases
• Assessment of intraocular pressure: To rule out possible glaucoma

The diagnosis is usually made quickly and painlessly. Once cataracts have been diagnosed, the next steps are discussed with the patient – for example, whether an operation is necessary or whether the progression can be monitored initially.

What happens after the diagnosis?

The diagnosis of cataracts is initially worrying for many – but it is no reason to panic. In most cases, it is an age-related process that can be treated well. The decisive factor is the correct assessment: how far has the lens opacity already progressed? And how severely is vision actually impaired?

The next steps depend on how strongly the symptoms affect everyday life and how quickly the clouding of the lens progresses.

Observation or surgery – what do specialists advise?

Most ophthalmologists recommend cataract surgery if your vision deteriorates noticeably in everyday life – for example when reading, driving or working at a computer screen. The procedure is minimally invasive, is performed on an outpatient basis and is one of the safest procedures in ophthalmology.

In early stages without noticeable restrictions, the progression can initially be monitored. Regular check-ups are important in order to detect changes at an early stage. Surgery is recommended if:

• Visual performance decreases significantly
• Everyday activities are restricted
• Increasing sensitivity to glare occurs
• Contrast vision decreases
• New glasses no longer bring any improvement

Treatment options: How cataracts are treated (cataract surgery with laser)

The only effective treatment for cataracts is surgery, in which the clouded lens is removed and replaced with an artificial lens. In many cases today, a modern, laser-assisted methodis used – precise, safe and gentle.

Laser cataract surgery (e.g. with the femtosecond laser) is possible:

• A precise incision in the cornea
• Precise dissection of the opaque lens
• Ideal positioning of the intraocular lens (IOL)

The procedure is outpatient, painless (usually under drip anesthesia) and only takes a few minutes per eye. Many patients report significantly improved vision on the following day.

Which lenses can help you see better

In addition to the classic monofocal lens, which enables sharp vision at a distance (usually into the distance), there are now modern premium lenses:

• Multifocal lenses: Allow good distance and near vision – often without glasses
• EDOF lenses (Extended Depth of Focus): Optimize the transition between different distances
• Toric lenses: additionally correct corneal curvature

The choice of artificial lens is made together with the ophthalmologist and depends on the individual’s visual needs.

Can glasses or contact lenses cure cataracts?

In short: No. Glasses or contact lenses can temporarily compensate for the symptoms of incipient cataracts – for example, in the case of reduced visual acuity. However, they do not correct the clouding of the lens of the eye. The cataract itself can only be treated by surgically removing the clouded lens.

So if you want to see clearly in the long term, there is no way around cataract surgery – especially as modern procedures today offer maximum safety and quality of life.

Tips for preventing clouding of the lens of the eye or cataracts

Even though cataracts are an age-related disease in most cases, their development can be delayed through a healthy lifestyle and targeted measures. This is because certain risk factors such as UV radiation, metabolic diseases or malnutrition can promote the clouding of the lens of the eye – long before the first symptoms appear.

These tips help to reduce the risk:

• UV protection: Always wear sunglasses with a UV filter when out in the sun to protect the lens of your eye from harmful radiation.
• Healthy diet: Focus on vitamin C, E, lutein and omega-3 fatty acids – for example in green vegetables, nuts, fish and berries.
• Avoid smoking: Nicotine promotes oxidation in the lens and significantly increases the risk of cataracts.
• Regular check-ups at the ophthalmologist: this way, incipient changes can be detected at an early stage.
• Check blood sugar and blood pressure: Diseases such as diabetes or high blood pressure are considered possible causes of accelerated lens opacification.
• Reduce eye strain: Sufficient breaks from screen work and good lighting relieve eye strain.