Recognize and treat cataracts

Of all eye diseases later in life comes stare (cataract) most common. In the Netherlands, almost half of 65 to 74-year-olds develop cataracts. Even 70 percent of people over 75 get cataracts. The disease can also develop in people over 40; even younger patients with cataracts are exceptional. Women are almost twice as likely to have it as men. In 2003, according to the National Institute for Public Health and the Environment (RIVM), an estimated 222,800 women in the Netherlands had cataracts and 120,900 men.

What’s going wrong?

Proteins in the lens clump together under the influence of aging. This makes the lens less bright. The clouding of the lens of the eye reduces vision. You can compare it to a window that is getting dirtier: it is also increasingly difficult to see through it.

And then?

It often takes years for vision to become blurry. The condition can gradually lead to visual impairment and eventually blindness. Because cataracts develop so slowly, patients often don’t notice that something is wrong until they see so much less that they go to the optician or ophthalmologist for stronger lenses or lenses. But stronger glasses can no longer reverse the blurring caused by cataracts.

What are the risk factors?

• Higher age.
• Heredity (if your parents, brothers or sisters have cataracts, you are more at risk).
• Eye injury (for example, a punch to the eye).
• Use of medications, such as corticosteroids (prednisone).
• To smoke.
• Excessive use of alcohol.
• Prolonged exposure to sunlight.

Does an eye test make sense?

Yes. The ophthalmologist or optometrist can easily determine whether you have cataracts. With a slit lamp that emits a narrow beam of light, it is possible to see whether there are any cloudiness in the lens of the eye. When should you go to the doctor? See your doctor or ophthalmologist if you have any of the following symptoms in one or both eyes: blurred vision; reading worse and worse, even with a reading glasses; seeing double; being blinded quickly in backlight; seeing distorted images; increasingly suffer from nearsightedness (you cannot see clearly what is far away); increasingly suffer from night blindness.

How is it treated?

Sometimes, early on, stronger lenses can improve far vision. Brighter light can also help with reading. The only effective (and very safe) therapy of cataracts is the surgical removal of the lens and replacing it with an artificial lens. This is possible at any stage of the disease, if the quality of life decreases. There are no medications, eye drops, or diets that can cure cataracts.

Ophthalmologist Hans Lemij, working at Rotterdam Eye Hospital and specialized in treating cataracts:

“You can compare cataracts with getting gray hair. It’s part of getting older. Cataracts are not a bad thing, because they can be treated very well. We operate much more often in an early stage of cataracts. People today make high demands on what they can see, they don’t want to keep walking around with cataracts. Why should you? It is a very safe procedure – the most performed operation in the world. Cataract operations are performed even in mountain huts in Nepal. In the Netherlands, a stare operation usually outpatient; the procedure takes less than an hour.”

Good for the eyes

You can easily reduce the risk of visual impairment and blindness due to cataracts.

• Have your eyes checked regularly. Especially if there are risk factors for cataracts, it is a must to have your eyes checked regularly. Are you suddenly less sharp? Always have your eyes checked immediately.
• Do not smoke. Smoking is one of the biggest risk factors for cataracts.
• Protect your eyes from UV radiation. Excessive sunlight is a risk factor for cataracts.
• Eat healthy. The scientific evidence is accumulating that a healthy diet protects against cataracts. Healthy: lots of green vegetables, lots of fruit and lots of unsaturated fatty acids (such as nuts, olive oil, fatty fish). Foods with a so-called low glycemic index contain carbohydrates that are absorbed slowly by the body, and are better for the eyes than foods with a high glycemic index (fast carbohydrates). Therefore, eat a lot of whole grain products, brown rice and legumes. The more fiber and the less processed the product is, the better. Examples of foods with a high glycemic index (and therefore a lot of unhealthy ‘fast sugars’) are cakes, cookies, white bread, white rice and sugary foods. There is also some evidence that high (but safe) dose vitamin C supplements protect against cataracts. This involves at least 360 mg of vitamin C per day.

To the optician, optometrist or ophthalmologist?

You can go to the optician for a normal eye test: measuring nearsightedness or farsightedness, the cylinder strength and the eye pressure. Optician is not a protected title. The designation ‘Recognised Opticians’ offers the guarantee that there is at least one MBO-certified optician in the shop. To have your eyes checked for cataracts or you can go to an optometrist and request an optometric examination.
Optometrists work at opticians’ shops and hospitals. Search via www.optometry.nl an optometrist near you (choose ‘Practice Finder’). An optometrist will always refer you to an ophthalmologist if you suspect an eye disease. For treatment you can only go to the ophthalmologist. You can of course also have your eyes checked by an ophthalmologist with a referral card from your GP. Only the ophthalmologist is reimbursed by the health insurer.