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.

A classification of cataracts according to the time or cause of their occurrence.

Age-related cataracts are the most common form of cataract (Cataracta senilis)

For many people affected, the first signs of cataracts appear from the age of 50 and become more pronounced as they get older: at over 70, around 50 out of 100 people suffer from cataracts. Around 5 percent of 70-year-olds and 10 percent of 80-year-olds suffer from a cataract that requires surgery. This is why it is also referred to as senile cataract. At 90 percent, it is the most common form of cataract and can lead to blindness if left untreated. Physical activity has a positive effect and can delay age-related cataracts.

Diabetics have a high risk of developing cataracts

Of the general diseases that cause cataracts, the metabolic disease diabetes mellitus is the most common. It not only leads to diabetic retinopathy or diabetic macular edema - diabetics also suffer from cataracts earlier than other people.

Accidents and medication can cause cataracts

Accidents in which the eye is injured can lead to the formation of cataracts. Some medications, especially cortisone, can also cause cataracts if they are taken over a long period of time.

Cataract after eye surgery

Cataract formation is often unavoidable after eye surgery to remove the vitreous body of the eye. For this reason, vitreous surgery is often combined with the replacement of the natural lens with an artificial lens, i.e. cataract surgery. Cataracts can also develop after filtration surgery (trabeculectomy).

Cataracts in developing countries

People in developing countries suffer from cataracts more frequently and at a younger age. Reasons for this include a lack of nutrition, a lot of sunlight and lifestyle habits. A rubella infection in the mother during pregnancy is also more common in developing countries, as vaccination protection is rare and can lead to cataracts in the unborn child. In contrast to the highly developed countries, people in the poorer countries of the world rarely have the means and opportunities to undergo cataract surgery in order to be able to see clearly again.

Cataracts due to early embryonic damage

If the mother is infected with rubella, mumps, hepatitis or toxoplasmoso pathogens during pregnancy, the unborn child is at risk of cataracts. The highest risk, between 40 and 60 percent, comes from a rubella infection.

Inherited cataracts (congenital cataracts)

Inherited cataracts account for around 1 percent of all cataracts.

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

You can determine the timing of the operation yourself. If your vision deteriorates due to the symptoms of cataracts to such an extent that you feel restricted in your daily life, you should consider surgery.

More safety in everyday life and when driving

We advise you not to delay cataract surgery for too long, as a clouded lens increasingly restricts your vision and poses a danger to you and others when driving or in many everyday situations. Falls and accidents simply happen more quickly if you can no longer see your surroundings clearly.

Reducing the risk of dementia

A study published in the journal JAMA Internal Medicine in December 2021 showed a link between the removal of the clouded lens of the eye through cataract surgery and a reduced risk of dementia.

As soon as we have replaced the cloudy lens with a clear artificial lens or intraocular lens, you will experience clear vision again. If you would like to live independently of reading glasses or varifocals after cataract surgery, you have the option of having so-called premium lenses implanted instead of standard lenses. These should be tailored to your individual visual habits and your eyes. It is important to choose a surgeon who is scientifically familiar with the optics and properties of premium lenses and can give you independent advice. Through detailed preliminary examinations and discussions with you, the intraocular lenses tailored to your needs or a combination based on the principle of over-flare vision will be selected.