When to have cataract surgery at the latest: The right time for surgery

A cataract diagnosis is not uncommon – especially in old age. However, while cataract surgeryis one of the safest procedures available today, many patients hesitate for a long time before making the decision. For fear of complications or uncertainty as to whether the time is right.

But what happens if cataract surgery is performed too late? Can your eyesight suffer permanently – or can the operation become more difficult? And is there really a point at which it is “too late”?

In this article you will find out:

• Which symptoms are a clear signal for surgery
• Why an early decision can safeguard your visual acuity
• The risks associated with advanced clouding of the crystalline lens
• And how modern artificial lenses open up new perspectives for a better quality of life

Cataracts – why the right time for surgery is crucial

Cataracts are one of the most common eye diseases in old age. It involves a gradual clouding of the lens of the eye, which no longer transmits light clearly to the retina. Initially, the symptoms appear harmless – a slight gray haze, diminishing visual acuity, blinding light. However, if the cloudy lens is not treated in time, vision can deteriorate permanently – in extreme cases there is even a risk of blindness.

How the cataract becomes noticeable

The symptoms of cataracts develop slowly. The most common signs include

• A gradual loss of visual acuity
• Difficulty reading, especially in dim light
• Double vision or sensitivity to glare, e.g. when driving a car
• Blurred colors and an overall “milky” vision
• Frequent change of spectacle prescription without any real benefit

In the early stages, this can often be compensated for with visual aids such as glasses or contact lenses. However, as the lens becomes increasingly cloudy, the eye loses vision, regardless of the lens power of the glasses.

What happens to the lens if you wait too long

If a cataract is not treated in time, the clouding of the lens increases continuously. The cloudy lens of the eye lets less and less light through and the image on the retina becomes blurred – even the most modern visual aids can no longer compensate.

The operation can also be more difficult if the cataract is too advanced. A severely hardened lens is more difficult to remove and the risk of complications during the procedure increases. Adjacent structures such as the cornea or pupil can also be subject to greater strain.

When should I have cataract surgery?

Cataract surgery is one of the safest and most common procedures in ophthalmology today – but many people still ask themselves the question: when is the right time to have cataract surgery? The answer depends on the individual level of suffering, the extent of the clouding of the lens and the recommendation of the treating ophthalmologist. The important thing to remember is that waiting is not automatically better – on the contrary.

Symptoms that are a clear signal for cataract surgery

Surgery should be seriously considered at the latest when cataracts impair everyday vision. Warning signs include

• Deterioration in visual acuity despite current glasses
• Sensitivity to light, especially at night or against the light
• Double vision in one eye
• Insecurity when walking or driving
• Difficulty reading, recognizing faces or colors

These symptoms indicate that the lens of the eye is already severely clouded – and that vision has deteriorated so significantly that it can no longer be compensated for with visual aids.

Why “too early” is rare, but “too late” can be risky

Many people hesitate out of fear or uncertainty – and hope that their vision will stabilize on its own. However, premature cataract surgery is rarely problematic, as the procedure is minimally invasive, performedon an outpatient basis and under local anesthetic. Today, modern procedures such as the Lensar laser or the implantation of aspherical lenses offer the highest level of safety and quality – even at the onset of cataracts.

However, if you wait too long, cataract surgery can become more difficult. A hardened or overripe lens increases the risk of complications, for example to the cornea, pupil or when inserting an artificial lens (IOL).

Is there a point at which surgery is no longer possible?

In very rare cases – such as severe clouding, additional eye diseases such as glaucoma or damage to the retina – cataracts can progress so far without treatment that surgery is no longer useful or possible. The risk of blindness also increases if a necessary cataract operation is delayed for years.

Risks of cataract surgery performed too late

Anyone who leaves cataracts untreated for too long risks more than just a deterioration in visual acuity. As the lens becomes increasingly cloudy, the challenges increase – both in everyday life and during the subsequent operation itself.

Restrictions in everyday life and when driving

The clouded lens of the eye primarily affects visual performance in difficult lighting conditions – for example at dusk, in backlighting or glare from headlights. Participation in road traffic is particularly critical. Many sufferers underestimate how severely their vision is already impaired – this can be a danger to themselves and others.

Further consequences in everyday life:

• Falls due to reduced depth perception
• Unsteady when climbing stairs or on uneven paths
• Difficulty reading, watching television or recognizing faces
• Loss of independence and mobility

Further challenges with advanced clouding of the lens

The more advanced the cataract, the more demanding the surgical procedure becomes. A severely hardened, overripe lens is more difficult to remove, which poses challenges even for experienced surgeons. In addition, the placement of the intraocular lens (IOL) can be technically more demanding – especially if there is also a corneal curvature or an unstable capsular structure.

Aftercare is also more complex: more frequent check-ups, longer recovery times and the risk of multifocal lenses or other premium lenses not working as desired are typical accompanying factors.

Possible complications for the retina and intraocular pressure

An untreated cataract can also negatively affect other structures in the eye. The increasing density of the lens can:

• Increase intraocular pressure and thus promote glaucoma
• Making it difficult to see the retina during examinations – which delays the diagnosis of other diseases
• Lead to an inflammatory reaction in the eye
• Increase the risk of retinal detachment in extreme cases

If cataract surgery is performed too late, in rare cases it is no longer possible to fully restore vision despite technical correction.

Advantages of timely cataract surgery

Timely cataract surgery not only provides more safety in everyday life, but also opens up significantly better options for lens selection and long-term quality of vision. The earlier cataract surgery is performed, the easier and less risky the procedure is – and the greater the chance of restoringfull vision.

See better before your eyesight deteriorates significantly

If the cloudy lens is removed before it becomes severely hardened or vision is completely clouded, patients benefit from:

• Shorter surgery duration and faster recovery times
• Lower complication rate
• Better fixation of the artificial lens
• A clear view without a long period of uncertainty

In addition, visual adaptation is easier after the procedure – the brain processes the new visual impressions more quickly if the visual acuity was not already greatly reduced.

Modern lenses – from standard to multifocal lenses

If you decide to have cataract surgery at an early stage, you can choose from a variety of modern artificial lenses – individually adapted to your own visual needs:

• Monofocal lenses for good vision at a distance
• Multifocal lenses for more independence from glasses – both near and far
• Toric lenses for the simultaneous correction of astigmatism
• Aspheric IOLs for better contrast and reduced light scattering