Cataract

A Cataract, Lens opacity or cataract is an eye disease that can appear in humans, especially in old age. This causes the lens of the eye to become cloudy. If left untreated, cataracts usually lead to blindness or severe visual disturbances. The typical first signs of cataracts are spongy and foggy visual disturbances and a strong sensitivity to light.

What is cataract?

Cataracts, also known as cataracts, are an eye disease in which the lens of the eye becomes cloudy and turns gray. If left untreated, the cataract leads to blindness. It used to be believed that a gray liquid ran over the lens of the eye. It is for this reason that the disease was given the name cataract (waterfall).

causes

Schematic representation of eye surgery for cataracts. Click to enlarge.

In the vast majority of cases (approx. 90%), cataracts are an old-age disease that mainly occurs after the age of 65. However, due to various causes, the disease can occasionally occur in younger years. These include, for example, the diabetes mellitus or side effects of certain drugs such as cortisone.

Years of exposure to harmful UV rays on unprotected eyes are also a possible cause. Hereditary predisposition can also favor the development of cataracts. In a few cases, cataracts are congenital. The causes are diseases of the mother during pregnancy, such as rubella.

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Symptoms, ailments & signs

At the beginning, cataracts cause a noticeable deterioration in vision. Accompanying this, the characteristic fog appears in the middle of the field of vision, which becomes thicker over time and blurs the perception. In the course of the disease, this fog spreads over the entire field of vision and causes colors, contrasts and contours to fade.

As a result, the spatial perception and thus the orientation ability of the person concerned deteriorate. As the disease progresses, there is usually an increased sensitivity to bright light. Activities such as reading or watching television are found to be strenuous and often cause headaches and dizziness. The type and severity of symptoms vary from patient to patient.

In the late stages, almost all sufferers experience severely restricted vision, which eventually leads to partial or complete blindness. The signs of cataracts show themselves not only to the patient, but often to relatives and friends as well. The sick are becoming increasingly unsafe when driving or doing physical activities. A strained facial expression with narrowed eyes is typical. Those affected also often go wrong when they want to pick something up.

course

The first symptoms of cataracts are increasingly blurred, blurred vision. Strong glare and reduced contrast vision also appear with the increasing opacity of the eye lens. The clouding process often takes years.

For this reason, many sufferers do not see a doctor until the disease is late. If the disease is very advanced, the pupil appears almost white. In the final stage, the pupil can also liquefy and become blind.

Complications

An untreated cataract leads to a continuous deterioration of eyesight and thus to massive restrictions of the person concerned in everyday life. Clouds of what is seen, blurred images and refractions of light in the field of vision increase. The treatment of a cataract is quite low-risk.

Less than one percent now have a serious complication in laser surgery. This includes, for example, the subsequent blindness of those affected (in less than 1: 1000 cases) or infections of the eye.

In around four percent of the cases, a so-called cataract occurs, which manifests itself in symptoms similar to the cataract itself. However, it can also be removed.

In the case of a lens transplant, hardly any complications are to be expected. Only the loss of the eye's ability to accommodate is lost with the use of an artificial lens. After all, it cannot do any active muscle work.

After a lens transplant, those affected have a fixed distance at which they can see clearly. Depending on the situation, this must be supplemented by suitable glasses.

Slight complications, such as fluctuations in eye pressure or swelling of the retina, can occur in around five percent of all eye operations. But they are to be treated with medication. The risk of cataract surgery is very low. These operations are the most common surgical interventions on humans.

When should you go to the doctor?

With cataracts, it is always advisable to see a doctor. In the worst case and especially without treatment, the disease can lead to complete blindness of the person concerned and should always be treated by a doctor. As a rule, early diagnosis and treatment can completely prevent possible visual problems or blindness. A visit to a doctor is necessary if the person concerned suffers from visual disturbances that occur relatively suddenly for no particular reason.

As a rule, eyesight is reduced and double vision or vision is veiled. However, a high sensitivity to light can also indicate the disease and should be investigated. The diagnosis and treatment is carried out by an ophthalmologist.

The hospital can also be visited in acute emergencies. Since the illness can in some cases also lead to psychological complaints or depression, a psychologist should also be consulted. Psychological treatment is particularly advisable in the case of complete blindness or severe visual problems.

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Treatment & Therapy

Cataracts cannot be cured with medication. There is only the option of surgically replacing the lens of the eye with an artificial lens. Surgical intervention is now a routine procedure and only involves limited risks. The surgical procedure is performed under local anesthesia and takes approx. 20-30 minutes per eye.

A distinction is made between two surgical techniques. In the majority of cases the extracapsular method is used.The lens capsule is opened, the diseased lens is smashed using a laser beam and then sucked off. With the intracapsular method, the entire lens capsule is removed. This method is seldom used because it involves more risks than the extracapsular method.

There are several options after removing the clouded lens. The most optimal and in most cases used option is to insert an artificial lens made of Plexiglas, silicone or hydrogel. Modern multifocal lenses have been used for some time so that those affected no longer need glasses after the operation.

Slight glare and reduced contrast vision, especially at night, can still remain. Another advantage of the artificial lens is that it never has to be replaced, but remains in the eye for life.

An alternative to using an artificial lens is wearing contact lenses. This option is only used in medically justified cases. The method of choice is the insertion of an artificial lens. After the operation, the eye takes about one to two months to heal. Heavy physical work or sports should not be done during this time, which will increase pressure in the eye. Swimming and saunas are also not appropriate during this time.

Forecast:

In most cases, the results of cataract surgery are so good that those affected achieve almost full visual acuity after the operation. However, if there are other eye diseases, it may be necessary to wear glasses or contact lenses even after the operation.

Outlook & forecast

The prognosis for a cataract can be very different. Due to the fact that the metabolic processes in the eye are very individual, an exact prognosis is not possible. It can only be assumed in any case that visual acuity will continue to deteriorate if the condition is not treated. It is also unlikely that the eyes will heal spontaneously. Blindness occurs after an indefinite period of time.

However, the prognosis for treatment is good. In this way, around 50 to 100 percent of visual acuity can be restored in patients who have only one cataract. If other eye diseases, such as glaucoma, are also present, the prognosis is slightly worse. In the presence of degenerative eye diseases that first led to cataracts, the prognosis is also worse.

A so-called cataract can also occur after successful treatment. This can occur months or years after treatment, but it is easy to treat. The occurrence of a secondary star can never be ruled out.

No symptoms are to be expected after cataract treatment. The artificial lens is durable for a lifetime and does not cause any discomfort. There is also no feeling of a foreign body in the eye to be expected.

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Aftercare

After cataract surgery (cataract or laser surgery), a bandage is placed over the eye to prevent irritation. Nevertheless, no cosmetics or the like should come into the area of ​​the association. The eyes should also be spared after the bandage has been removed and protected from possible irritation.

Therefore, physical exertion such as sport or physical work should be avoided initially. This can increase the pressure in the eye, which can put the recently operated eye at risk. Likewise, no activities should be carried out in which dirt or dust can collect in the eyes. Wound healing is supported by appropriate eye drops after the operation.

Above all, regular follow-up visits to the ophthalmologist with appropriate controls and measurements are important. Eyesight measurements can also be carried out by the optician, but only the doctor can control the healing process and tell you when you can resume all physical activities as usual.

In addition, an ophthalmologist can identify possible risks such as "cataract". As a rule, you can order new glasses four to six weeks after the operation, when the eye has got used to the new artificial lens.

You can do that yourself

The period in between until the cataract surgery can be bridged with a few measures to make everyday life easier.

Wearing a peaked cap, baseball cap or a wide-brimmed hat reduces glare when you are outdoors. Sunglasses can be worn instead of or in addition to headgear.

It is very likely that visual acuity will decrease somewhat by the time the cataract is ready for surgery. It is therefore important to structure your home and workplace and to create contrasts. So the table can be set with a high contrast. Contrasting dishes are suitable as a contrast to the table. Another variant are high-contrast coasters for the dishes. Color-tinted drinking glasses are available in stores.

They help to see the glass better and to avoid accidental knocking over. Another way to avoid tipping the glasses over is to move the palm of your hand to the side, touching the table, and to feel the glass on the floor. The angle at which the shoulder joint, elbow and wrist work can be easily memorized.

For cooking, the required amount of spice can be tipped into the cupped hand. The level of liquids in a container can be easily heard: the higher the liquid level in the container, the higher the tone. In addition, you can remember the time that passes by turning on the tap.

Magnifying visual aids may be needed temporarily. The nearsighted cataract patient sees better if he approaches the object closely and takes off his glasses.