Incipient cataracts symptoms and treatment: Everything you need to know as a cataract patient

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 – medically known as cataract. 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 cause no pain – and vision deteriorates so gradually that the change is often not noticed until late.

Particularly insidious: Those affected unconsciously get used to the “new vision”. It is only when the clouded lens significantly impairs visual acuity or affects activities such as reading, watching television or driving that the ophthalmologist is consulted – often later than would be optimal.

Therefore: Anyone who notices one or more of the above symptoms should have the diagnosis of cataracts clarified early. 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

With cataracts, there is a gradual clouding of the lens of the eye – a clear, elastic structure directly behind the pupil. Due to the natural ageing process, but also due to factors such as diabetes, UV radiation or certain medications, the lens structure changes: protein molecules clump together, the lens loses its transparency – it becomes clouded.

This clouding allows less light to reach the retina and affects visual quality: contrasts fade, colors appear duller, vision in backlight becomes more difficult. In the early stages, this is hardly noticeable – but if left untreated, 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 simpler and more successful the treatment. A visit to the ophthalmologist is particularly advisable if visual acuity changes, the image appears blurred or sensitivity to glare occurs. Even if new glasses no longer bring any improvement, this can be an indication of incipient clouding of the lens.

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

What happens for cataracts to be diagnosed

If cataracts are suspected, the ophthalmologist carries out a targeted examination. This includes:

• Visual acuity test: Determines whether vision has deteriorated
• Slit lamp examination: The lens of the eye is examined directly using a special microscope – even early clouding 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 together with the patient – for example, whether surgery is necessary or whether the progression can initially be monitored.

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 right assessment is crucial: How far has the clouding of the lens already progressed? And how severely is vision actually impaired?

The next steps depend on how much the symptoms affect everyday life and how quickly the clouding of the lens is progressing.

Monitor or have surgery – what do specialists advise?

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

In early stages without noticeable impairment, the progression can initially be monitored. Regular check-ups are important here to detect changes early. Surgery is recommended when:

• Vision deteriorates significantly
• Everyday activities are restricted
• Increasing sensitivity to glare occurs
• Contrast vision deteriorates
• 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 method is used – precise, safe and gentle.

Cataract surgery with laser (e.g. with the femtosecond laser) enables:

• A precise incision in the cornea
• Exact fragmentation of the clouded lens
• Ideal positioning of the intraocular lens (IOL)

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

Which lenses can help with better vision

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

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

The selection of the artificial lens is made together with the ophthalmologist and depends on individual 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 surgical removal of the clouded lens.

So anyone who wants to see clearly permanently cannot avoid cataract surgery – especially as modern procedures today offer the highest safety and quality of life.

Tips to prevent clouding of the lens of the eye or cataracts

Even though cataracts are in most cases an age-related disease, 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 clouding of the lens of the eye – and this long before the first symptoms appear.

These tips help reduce the risk:

• UV protection: Consistently wear sunglasses with UV filter in the sun to protect the lens of the 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 preventive examinations with an ophthalmologist: This way, incipient changes can be detected early.
• Monitor blood sugar and blood pressure: Diseases such as diabetes or high blood pressure are considered possible causes of accelerated clouding of the lens.
• Reduce eye strain: Sufficient breaks when working at a screen and good lighting relieve the strain on the eyes.