Cataract Surgery

Cataracts are an eye disease that affects millions of people worldwide. They affect the quality of life of those affected and can even lead to loss of vision. This makes it all the more important to recognize the first symptoms of the disease early and to use the treatment options available for cataracts as quickly as possible.

What is a cataract?

Cataracts disease affects the lens of the eye, which is normally clear and transparent. In cataracts, the lens gradually becomes cloudy, which leads to impaired vision. Affected patients only see the world around them in a blurred and hazy way. If left untreated, cataracts can significantly impair quality of life and, in the worst case, lead to blindness.

At what age do most people get cataracts?

Cataracts are primarily an age-related eye disease. Most people will develop cataracts at some point in their lives, and the risk increases with age. Cataracts are generally more common in people over the age of 60, but younger people can also be affected, especially if certain risk factors are present.

As you get older, the risk of developing cataracts increases significantly. This is because the proteins in the lens of the eye change structure and become cloudy over time. In fact, most people will develop some form of cataracts at some point in their lives, but not all of them require immediate treatment.

Do cataracts also occur in children?

Yes, cataracts can occur in children, although this is rare. There are many different causes of pediatric cataracts. Most commonly, they occur due to genetic factors, illnesses during pregnancy, injuries, or infections. If cataracts are treated early, most affected children can develop normal vision.

Can cataracts regress?

Cataracts do not go away on their own. They are a progressive eye disease. Once they have developed, cataracts do not go away on their own and usually require medical treatment to improve vision.

Cataracts: Causes of the eye disease

There are various factors and causes that can contribute to the development of cataracts. The most important risk factor for the development of cataracts is age. This form of eye disease is also known as “age-related cataracts”.

In addition, there are several other risk factors that promote cataracts:

• Genetic predisposition
  A family predisposition can play a role when researching the causes of cataracts. If cataracts have already occurred in the family, there is an increased risk of suffering from the disease yourself.
• UV radiation
  If you expose your eyes to excessive UV light, the risk of cataracts is increased.
• Smoking
  Smoking cigarettes is a known risk factor for the development of cataracts.
• Diabetes
  People with diabetes also have a higher risk of developing cataracts at some point in their lives. Regular blood sugar monitoring is therefore important.
• Eye injuries
  Injuries or trauma to the eye can also lead to the onset of the disease.
• Medications
  The long-term use of certain medications, such as corticosteroids, increases the risk of cataracts.

Different forms of cataracts according to the location of the lens clouding

The clouding of the lens in the eye can occur in various places. This also determines which symptoms occur and how the disease develops over time.

Cortical cataract: In a cortical cataract, the clouding occurs in the outer layer of the lens, called the cortex. This form of cataract causes the edges of the lens to become opaque. People with a cortical cataract may experience symptoms such as glare, streaked vision, and difficulty switching between different lighting conditions.

Posterior subcapsular cataract (PSC): This cataract occurs at the back of the lens, just beneath its capsule. It can develop more quickly than other types of cataracts and often results in worsening of near vision and increased sensitivity to glare. People who take steroids or have certain diseases such as diabetes are at increased risk of developing a posterior subcapsular cataract.

Nuclear cataract: In a nuclear cataract, the clouding is in the middle (the core) of the lens. This is one of the most common forms of cataract, which mainly occurs in old age. Those affected often perceive the disease as a “two-part” or “two-layered” visual impairment.

Cataract symptoms: This is how a cataract makes itself noticeable

Like many other eye diseases, cataracts only become noticeable gradually. In addition, the disease is completely painless. Nevertheless, there are some symptoms in the early stages that indicate cataracts.

Blurred vision: The most common symptom is increasingly blurred vision that gradually gets worse. The surroundings appear blurred or foggy, as if you were looking through a milky veil.

Light sensitivity: Affected people are often more sensitive to bright light. They react strongly to direct sunlight or headlights at night. Sensitivity to glare gradually increases. As the disease progresses, it becomes increasingly difficult to see in bright light or near light sources.

Problems reading and seeing at dusk: Reading printed text or recognizing faces in poorly lit areas can be difficult.

Reduced contrast vision: The ability to perceive differences between light and dark areas gradually decreases with cataracts. You can see fewer and fewer details.

Altered perception of colors: Some people with cataracts report altered perception of colors. Colors may appear less bold or vibrant.

Double vision: In some cases, double vision or multiple vision may occur, especially with advanced cataracts.

Steps of Diagnosis at the Ophthalmologist

If you feel the first symptoms of cataracts, make an appointment with an ophthalmologist as soon as possible. The doctor will talk to you about your symptoms and ask questions about your medical history. This will help him or her find out whether you already have risk factors for cataracts, such as diabetes or a family history.

As part of a thorough examination, the doctor will check your vision, pupil reaction and intraocular pressure. The front and back sections of the eye will also be examined using a so-called slit lamp microscope. A special focus of the examination is on evaluating the lens. The doctor will look closely at the lens in your eye to see if it is cloudy or opaque. This is the characteristic feature of cataracts. To determine the degree to which your vision is impaired by the cataracts, your doctor will then carry out various vision tests, such as the visual acuity test.

Cataracts: This is how the disease progresses

In the early stages of cataracts, most people do not notice any significant symptoms. The clouding of the lens develops slowly and has little impact on vision. Over time, the clouding of the lens becomes more severe and those affected begin to notice symptoms. may begin to notice symptoms. These include blurred vision, sensitivity to glare, increased sensitivity to light. As the disease progresses, patients develop the typical “staring stare”

The clouding of the lens progresses over time and eventually affects vision. Everyday activities such as reading, driving and recognizing faces become increasingly difficult. If cataracts are not treated, they will eventually significantly reduce the quality of life. Vision deteriorates, those affected lose their independence and can only cope with everyday life with severe limitations.

Cataract Treatment: What You Can Do

Unfortunately, there are no medications that can be used to treat cataracts. Therefore, there is only one long-term treatment option for cataracts: surgery. Until then, you can often compensate for the impairments with visual aids.

When is the right time for surgery?

There is no clearly defined optimal time for an operation. If the cataract significantly affects your vision and seriously interferes with your daily activities such as reading, driving, watching TV or working, then you should consider an operation. However, you don’t have to wait until the suffering has already built up. It is worth reacting much earlier, before your independence and quality of life are so severely impaired. Once the cataract has been diagnosed, the ophthalmologist will examine your eyes regularly and monitor the progress of the eye disease.

What surgical methods are there for cataracts?

The operation is carried out with the aim of replacing the old, hardened lens with a new, artificial lens in the eye. Cataract surgery is now a routine procedure, but should only be carried out by an experienced eye specialist.

This is how the operation usually proceeds:

1. Step: Preparing for the procedure
   Before surgery, your eye doctor will perform a thorough examination of your eyes to determine the exact power of your intraocular lens (IOL) that will be inserted after surgery.
2. Step: Anesthesia
   Most cataract surgeries are performed on an outpatient basis. Patients are given only local anesthetic drops or injections to make the eye pain-free. Since many patients are very agitated, they are given mild sedatives to help them relax a little  to numb them. In some cases, a mild sedative may be given to help you relax.
3. Step: Opening the cornea
   The surgeon makes a small incision in the anterior capsule of the lens or in the cornea to gain access to the clouded lens.
4. Step: Removing the clouded lens
   The clouded lens is broken into tiny pieces using a special technique such as phacoemulsification or extracapsular extraction and then suctioned out.
5. Step: Implantation of an artificial lens
   After the cloudy lens is removed, a clear artificial lens called an intraocular lens (IOL) is inserted into the eye. This IOL stays in the eye permanently and helps improve vision.
6. Step: Closure of the incision
   The incision will then either heal on its own or be closed with one or two stitches, depending on how exactly the surgery was performed.

How long is the recovery time after the procedure?

The cornea is usually still a little dry after the operation. It needs time to regenerate. But improvement is usually noticeable after just a few days. It takes about 4 to 6 weeks for the eye to heal completely after the operation and for the new lens to grow in firmly.

Can you see normally again after cataract surgery?

Yes, in most cases, people can regain normal vision after successful cataract surgery. They often notice a significant improvement in their vision immediately after the procedure. Although the cloudy lens of the eye is removed, the artificial intraocular lens (IOL) implanted during the surgery cannot respond to changes in eye length over the course of a lifetime. Therefore, you may need glasses after surgery for the best visual outcome, especially for reading or looking at objects close up.

Can the cataract come back after the procedure?

After successful surgery, cataracts usually cannot recur. Removing the clouded lens and replacing it with an artificial intraocular lens (IOL) is a permanent solution. The artificial lens is not susceptible to the same type of clouding as the eye’s natural lens.

Can I effectively prevent cataracts?

Since most cataracts are age-related or genetic, there is no reliable way to prevent cataracts. However, you can reduce certain risk factors for the development of cataracts by making small changes in your behavior.

• Quit smoking
  Cigarettes are a known risk factor for developing cataracts. If you quit smoking, you will reduce your risk of developing cataracts.
• Sun protection
  If you repeatedly expose your eyes to the sun for long periods of time without protection, then the risk of cataracts increases. Therefore, wear sunglasses outdoors in the summer.
• Healthy diet
  A balanced diet rich in antioxidants can help maintain eye health. Eat foods such as fruits, vegetables (especially green leafy vegetables) and fish, which are rich in vitamins and antioxidants.
• Diabetes control
  Diabetes is another risk factor for developing cataracts. Therefore, if you have this disease, have your blood sugar levels checked regularly.

It is also recommended that people over the age of 40 schedule a check-up with an ophthalmologist every two years and over the age of 60 every year. As part of an early detection test, abnormalities in the eye are quickly detected.