Frequently asked questions about cataracts

Typical signs are increasingly blurred or cloudy vision that glasses can no longer fully correct, greater sensitivity to glare (especially when driving at night), faded colours and the feeling of looking through a veil. Only an ophthalmologist can make a reliable diagnosis, using a slit-lamp examination.

Yes. In most cases a cataract develops in both eyes, though often at a different pace. One eye can be more affected than the other. Even so, the eyes are usually operated on one after the other, a few weeks apart.

No, these are two completely different conditions. A cataract (clouding of the eye’s natural lens) can be cured by surgery. Glaucoma is raised pressure inside the eye that damages the optic nerve; it cannot be cured, but it can be treated. Both can occur at the same time, yet they differ in cause, symptoms and treatment.

No. There is no medicine, no eye drop and no pair of glasses that can make a clouded lens clear again. Vitamin preparations and dietary supplements have no proven effect. The only effective treatment is surgery, in which the cloudy lens is replaced with a clear artificial lens.

That varies a great deal. Age-related cataract usually develops slowly over years. Some people hardly notice any change for years; in others, vision worsens noticeably within a few months. With diabetes, after injuries or during cortisone therapy, progression can be faster. Regular check-ups with your ophthalmologist show how far the cataract has advanced.

Age-related cataract usually begins from around the age of 60. Among 70- to 80-year-olds, about one person in two is affected; among the over-80s, more than seven in ten. Less often, a cataract appears earlier, for example through diabetes, injuries or cortisone, or is present at birth.

There is no fixed threshold. Surgery is done when the loss of vision restricts your daily life, for example when driving, reading or watching television. It also makes sense when glasses can no longer improve your visual acuity sufficiently. Your ophthalmologist assesses the situation and advises you individually.

Technically yes; a cataract is not an emergency. A very dense cataract can, however, make the operation more difficult later on. The risk of falls due to poor vision also rises over time. Waiting longer is reasonable while the visual impairment is still minor. Your doctor can judge how urgent the procedure is in your case.

Not with the usual drop anaesthesia (local anaesthesia), which is used in over 95% of cases. If you have a general anaesthetic (very rare in adults), the usual fasting rules apply (6 hours, no food or drink). Your doctor will inform you in good time.

Blood thinners (aspirin, Marcoumar, NOACs) are usually NOT stopped; the risk of bleeding in the eye is minimal with this operation. You must, however, report tamsulosin and other alpha-blockers (commonly taken for prostate conditions): they raise the risk of an iris syndrome (IFIS) and the surgeon needs to know about them. Always bring your complete medication list.

As a public-insurance patient you should expect about 6 to 12 months, depending on the clinic and the province, often longer in urban areas. As a private patient, or with suitable supplementary insurance, you usually get an appointment within 1 to 4 weeks. If your visual acuity is severely reduced or your safety in daily life is at risk, talk to your doctor about an earlier date.

At the preliminary examination your eye is measured precisely. The most important measurement is biometry (measuring the eye), from which the right power of the artificial lens is calculated. Added to this are a slit-lamp examination and a check of the retina and the eye pressure. In the consultation, you and your doctor decide which lens type suits your daily life. The examination is painless and usually takes less than an hour.

Yes. The surgery is performed under drop anaesthesia: you are awake, but the eye is completely numb. You see light and blurred movement, but no details of the procedure. Many patients describe it as relaxed. You can be given a mild sedative if you wish.

No. The eye is completely numb. Some patients describe a slight feeling of pressure, but no pain. After the surgery the eye may burn or feel irritated for a few hours; this settles quickly.

The procedure itself takes 10–20 minutes. Including preparation and observation afterwards, you spend about 2–4 hours in hospital. Most patients go home the same day.

A small lid holder keeps the eye gently open, so you do not have to fight the urge to blink. The eye is numb and barely moves. If you feel uncomfortable, simply say so instead of moving suddenly. The surgeon is prepared for small movements, and a mild sedative is available if needed.

The eyes are usually operated on separately, typically 1 to 4 weeks apart. This allows the result of the first eye to inform the lens power calculation for the second. Operating on both eyes on the same day is possible in certain cases, but the approach depends on the surgeon and the clinic.

Many patients report much better vision as early as the next morning. Healing takes 4–6 weeks until visual acuity is fully stable. Only then should new glasses be fitted.

That depends on the artificial lens you choose. With a standard monofocal lens (covered by public insurance) you usually see well at distance but need reading glasses. With a trifocal premium lens, over 80% of patients manage daily life without glasses. Your doctor discusses the options with you before the surgery.

The artificial lens itself does not cloud over. However, the posterior lens capsule, which holds the lens in place, can cloud over after months or years: this is posterior capsule opacification (PCO), often called ‘secondary cataract’. It occurs in 20–40% of patients and is fully corrected with a 5-minute laser procedure (YAG capsulotomy). This procedure is covered by the ÖGK (Österreichische Gesundheitskasse, Austria’s largest public health insurer).

Not straight away. Driving is only allowed once your ophthalmologist has confirmed at a check-up that your visual acuity is sufficient. As a rule this is the case after about one to two weeks. Do not get behind the wheel without this confirmation, even if you feel you already see well.

In the first one to two weeks you should not rub the eye, not swim, not use a sauna and not wear eye make-up. It is best to avoid heavy lifting, bending down head-first and strenuous physical exertion. Watching television, reading and light everyday activities, on the other hand, are allowed straight away. Your doctor will give you the exact rules.

A feeling of dryness, with scratching or the impression of a grain of sand in the eye, is common after the surgery and harmless. The small incisions and the eye drops temporarily disturb the tear film. Lubricating artificial-tear drops help, ideally without preservatives. The symptoms usually settle on their own within a few weeks.

Yes, such light phenomena (dysphotopsia) are not unusual in the first weeks. Some people notice halos, glare or bright arcs of light; others see a crescent-shaped dark shadow at the outer edge. It is caused by the way light is refracted at the new artificial lens. In the vast majority of cases the brain gets used to it and the perception disappears. If it remains disturbing, talk to your doctor.

With monovision, both eyes receive standard monofocal lenses: one eye is set for distance, the other for near vision. The brain learns to merge the two images into one coherent picture. Monovision is fully covered by the ÖGK, because both implanted lenses are standard monofocal lenses. The prerequisite is a short trial with contact lenses to check whether the principle feels comfortable for you. Not everyone tolerates monovision, but for suitable patients it is an attractive way to gain more independence from glasses at no extra cost.

Yes. The operation with a standard monofocal lens is free of charge for everyone insured with the ÖGK, including anaesthesia, the preliminary examination and aftercare. You only pay extra for premium lenses (toric, EDOF, trifocal) or FLACS laser surgery.

Public-insurance patients only pay a surcharge: toric lenses about €400–800 per eye, EDOF lenses €700–1,200, trifocal lenses €1,000–1,500. As a fully private service, the total cost including the operation is roughly €2,500–3,000 per eye for a standard lens and €3,500–4,500 per eye for a premium lens. All amounts are approximate guide values, not fixed prices. More on this on the costs page.

In most cases, yes. Private supplementary or special-class (Sonderklasse) insurance usually covers most of the costs; you are then treated as a private patient and practically everything is included. This matters especially with policies that cover hospital stays: the operation is nowadays usually done as a day case (outpatient), but many of these policies still pay for it. The best way to find out whether your policy applies is to ask the surgeon directly; most know the common insurers well.

Yes. In Austria, medically necessary surgery costs, including surcharges for premium lenses, can be claimed as an extraordinary burden (außergewöhnliche Belastung) in your tax return, provided the income-dependent threshold is exceeded. Keep all invoices and hand them to your tax adviser. With premium lenses in both eyes, the deductible amounts can quickly add up to several thousand euros.

Yes. The artificial lens (intraocular lens) is made of a stable plastic that does not wear out and does not cloud over. It is designed to last a lifetime and normally never needs replacing. If vision worsens again after months or years, the cause is usually posterior capsule opacification, a clouding of the capsule behind the lens, which is corrected with a short laser procedure.

An exchange is technically possible but rarely necessary. It may be considered, for example, if the calculated lens power differs markedly from the target, or if a premium lens is permanently not tolerated. An exchange is easiest in the first weeks after the surgery. Whether it makes sense is a decision the surgeon takes together with you.

No. The lens sits inside the eye, in the place of the former natural lens. It is not visible from the outside, and you cannot feel it. All you notice is the result: clearer vision.

That is very rare. The lens is placed in the natural capsular bag, where it settles firmly into position. Slight displacement (decentration) occurs in individual cases, for example after injuries or with very weak connective tissue. If it causes problems, it can be corrected with a small procedure.