What is a cataract? First symptoms of cataracts

A cataract is an opacity of the lens that, if left untreated, leads to impaired vision that hinders daily functioning and often results in complete loss of vision.

The World Health Organization lists unoperated cataracts as the cause of 35% of all cases of reversible blindness worldwide. Until recently, only mature cataracts were operated on, but now ophthalmologists take the position that cataract surgery is advisable even in the early stages, as long as the visual impairment is severe enough to impede daily functioning.

However, we wrongly associate cataracts only as a disease of the old. Cataracts take many forms.

Acquired/degenerativecataracts(cataracta acquisita), also known as senile cataracts, are referred to as the silent thief of the eye – because they take years to develop and often go completely unnoticed. But cataracts can be contracted at any age, nay, you can be born with it!

Congenitalcataracts(cataracta congenita) arise as a result of metabolic or chromosomal aberrations, ocular malformations, hereditary conditions, intrauterine infections, and in situations where the fetus in the womb is exposed to certain drugs.

Between congenital cataracts and acquired cataracts– the former affecting the youngest and the latter the oldest – is still cataract complicata.

It just appears as a complication after another eye disease (or in the case of large visual defects) or a systemic disease. Secondary cataracts will also include so-called “cataracts”. Drug-induced cataracts, i.e. arising from the adverse effects of certain drugs, such as steroids.

In the professional literature we can find a very extensive division of the types of cataracts, depending on m. in. from its localization, cause, course, time of occurrence or treatment. However, we are most interested here in acquired/degenerativecataracts(cataracta acquisita, senilis), i.e. senile cataracts, because, as already mentioned, cataracts that are not operated on in time are the cause of 35% of all cases of reversible blindness worldwide, and we are able to catch the first signs of them ourselves and take treatment quickly.

If, in addition, you are in the risk group, it is worth knowing that while some of the causes of lens clouding are beyond our control, sometimes, however, through proper hygiene or diet, we can significantly slow down the process and take care of regular check-ups with the ophthalmologist.

Who is at risk?

Certainly people in whose family cataracts have already occurred. In addition, all those diagnosed with, among other things:

• diabetes
• galactosemia and other metabolic diseases
• atopic dermatitis
• Werner’s syndrome
• Rothmund syndrome
• Lowe’s syndrome
• Fabry disease
• Down syndrome
• hypertension
• hypercholesterolemia
• PEX (pseudoexfoliation syndrome)

The use of certain medications (such as steroids), obesity, smoking, alcohol abuse, overexposure to UV rays and also high myopia predispose to cataracts.

We have a strongly limited influence on the occurrence of many diseases, but there are some to the occurrence of which we are instrumental, such as hypertension. Optimal diet, a healthy lifestyle, and the use of ergonomic principles in the workplace, on the other hand, are things we can influence consciously and voluntarily.

First signs of degenerative cataracts

The beginnings of cataracts may not be noticeable – just a deterioration of vision, which we put down to exhaustion. However, when such symptoms as:

• deterioration of distance vision
• problem with perception and color discrimination
• better vision on cloudy days
• seeing objects “as through a dirty glass”
• Deterioration of self-care due to visual impairment

persist for some time and do not disappear despite the fact that we are rested and do not find any objective reasons for their occurrence, let’s rush to an ophthalmologist. In the early stages of cataracts, the doctor may order eye drops, but if they do not have the desired effect, lens replacement surgery will be necessary.

How is acquired cataract diagnosed?

An experienced doctor only needs to see the cloudy lens with dilated pupils. Rather, the fundus examination is designed to assess the quality of vision after the procedure and to evaluate the risks of the procedure to the retina.

It is worth remembering that cataracts develop gradually, from the incipient cataract (the opacity occurs only at the periphery of the lens), through the advanced, immature cataract, to its mature form, when the opacity of the lens is complete. Transperitoneal cataracts, on the other hand, are already a stage in which the lens fibers gradually liquefy, causing the lens nucleus to move downward, which can further lead to irreversible blindness.

Most importantly: in the course of the formation of acquired cataracts, there is time to diagnose this insidious disease and stop its degenerative effects – and thus save sight.

In the early stages of cataracts, drugs can be administered in the form of drops, but their action does not always have the desired effect. In fact, the only effective way to eliminate senile cataracts is surgery to remove them.

Methods of cataract removal

Cataract phacoemulsification – a method of removing cataracts using an ultrasonic tip and implanting an artificial intraocular lens. The procedure is performed under surface anesthesia applied as a gel or drops into the conjunctival sac. In place of the removed lens, a new one is inserted – a flexible, retractable, acrylic lens that unfolds on its own in the natural lens bag and settles in the right place in the eyeball. The incision is minimal (1.5 to 3 mm).

High-precision femtosecond laser surgery – a method that involves making micro-incisions (called ports) in the cornea and removing the cloudy lens through them and then inserting a new lens. The treatment takes 10-15 minutes.

Cataract surgery with the Ziemer Z 8 femtosecond laser!