What is a cataract, and how is it treated nowadays?

The eye's lens (Greek: "phakos") is an organ without nerves and vessels. It consists of a lens capsule and a nucleus. Like the lens of a camera, the eye's lens is crystal clear and has a convex curve on both sides. As a converging lens, the natural lens bundles the light entering the eye and focuses it on the retina. Due to its elasticity, it can flatten out or shape into a ball to change the focal point on the retina in doing so.

Over the course of our life, the lens changes all the time: New cells are produced in the nucleus, causing the lens to become thicker and less flexible over the years. If the lens loses its elasticity, its refractive power also changes, and nearby objects appear to be increasingly fuzzy. This process causes presbyopia and usually a dependence on reading glasses.

If a cataract is present, there are changes taking place inside the eye lens as well. In it, there are highly concentrated proteins which remain transparent due to the protective proteins a-crystallin (cryAA) and b-crystallin (cryAB). If these so-called crystallins fail, the proteins clump together and cause the clouding of the lens typical for a cataract. This causes scattering of the light entering the eye - as a consequence, the vision becomes blurry. Reading glasses cannot help manage the clouding of the lens; the only way to manage it is the cataract operation.

The causes of cataracts have not been established definitely. So far, oxidative stress was considered one of the factors causing the restructuring processes in the fibrils in the eye's lens. Other factors contributing to cataracts are:

• Natural aging processes
• Sunlight UV rays
• Infrared radiations
• Too little physical activity
• Smoking
• Diabetes
• Malnourishment
• Injury of the eye
• Medication
• Rubella during pregnancy can also cause a cataract in babies

Senile cataracts are the most frequent type of cataract

In many people affected by cataracts, first signs of clouding of the lens occur as early as 50 years of age and become more pronounced in the course of the patient's life: At an age of over 70, around 50 of 100 persons have a cataract. Therefore, it is also referred to as a senile cataract. It is the most frequent type of cataract and can cause blindness if it is left untreated. Physical activity has a positive effect and can delay senile cataracts.

Cataracts in the developing world

People in the developing world have cataracts more frequently and at a lower age. Reasons for this are for example malnourishment, lots of sunlight and the lifestyle. A rubella infection of mothers during pregnancy also occurs more frequently in the developing world since there is rarely any vaccinal immune protection, and it can cause a cataract in the unborn child. Contrary to the highly developed countries, people in the poorer countries of the world are rarely able to get the means and options to undergo a cataract operation to be able to see clearly again. However, the Christoffel Blindenmission is helping these people, which is why we are supporting this organization. Read more about it in the chapter on social activism.

People with diabetes are at a high risk of having a cataract

The metabolic disorder diabetes mellitus also affects the eye and does not only cause a diabetic retinal disorder (retinopathy). Persons with diabetes also develop a cataract earlier than other people.

Accidents and medications can cause a cataract

Accidents in which the eye was injured can cause development of a cataract. Some medications, in particular cortisone, can also cause a cataract if they are taken over a longer period of time.

A cataract can also be a consequence of some eye operations

In an eye operation in which the eye's ciliary body is removed, development of a cataract cannot be avoided in frequent cases. For this reason, a ciliary body operation is frequently combined with replacement of the natural lens by an artificial lens, i.e. a cataract operation.

Do not wait too long to have the cataract operation since poor vision can be a danger to you and other people.

Good news first: Contrary to a glaucoma, the damage to the eye's lens caused by the cataract can be repaired completely by a cataract operation: As soon as we replace the clouded lens by a clear synthetic lens, you will once again have the clear vision you were used to in the past. By using a premium lens with several focal points, you can even regain independence from your reading glasses.

Nevertheless, we recommend that you do not postpone the cataract operation for too long since a clouded lens will increasingly impair your eyesight and is a danger for you and other people while driving or in many other situations in your daily life. Falling and accidents just happen more quickly if you are no longer able to see your environments clearly.