Frequently asked questions about cataract

Cataract is a gradual clouding of the natural crystalline lens of the eye. The lens consists of specific proteins that are normally crystal-clear. With cataract these proteins deteriorate, the lens becomes cloudy and light no longer focuses sharply on the retina. The result is blurred, low-contrast vision.

None — 'staar' is the Dutch word for cataract. Both terms refer to the same condition: clouding of the crystalline lens.

In the vast majority of cases cataract is a normal ageing process. Other causes: diabetes, long-term corticosteroid use, eye trauma, prolonged UV exposure, smoking and hereditary factors. Cataract can also be congenital.

Cataract is most common after the age of 55. Beyond 75, the majority of people have some degree of cataract. At a younger age it can occur due to diabetes, medication, trauma or hereditary predisposition.

Usually yes, but the progression can differ between the two eyes. We typically operate on the more troublesome eye first and the second eye a few weeks later.

Very variable — from a few months to several years before it becomes bothersome. Some patients notice barely any change for years, others see a clear deterioration within a few months.

No. Cataract is a progressive process that can only be resolved with surgery. No drops, diet or glasses can reverse the clouding.

No. Despite extensive research, no medication currently exists that can prevent, slow or cure cataract. The only effective treatment is surgery, replacing the cloudy lens with an artificial intraocular lens (IOL).

Since cataract is largely an ageing process, it cannot be fully prevented. You can reduce the risk: UV protection (sunglasses), no smoking, good diabetes control, a diet rich in antioxidants and omega-3, avoiding long-term corticosteroid use.

Typical complaints: gradually blurred or milky vision, reduced contrast, duller colours, glare from bright lights and headlights, frequently changing spectacle prescription, double vision in one eye and a haze that does not clear when blinking.

If in doubt, book an appointment with the ophthalmologist. During the slit-lamp examination the lens is inspected and the presence, severity and type of cataract can be identified immediately.

Yes. In early cataract the prescription often shifts towards myopia — some patients can temporarily read up close again without reading glasses ('second sight'). As cataract progresses, no spectacle correction is sufficient anymore.

No. Cataract itself causes no pain. It is a painless, gradual process. Increased light sensitivity can however be bothersome.

Yes. Cataract can cause monocular diplopia (double vision in one eye) — the image looks doubled or has a 'ghost'. It disappears when the other eye is closed, in contrast to double vision from strabismus, which disappears when either eye is closed.

Yes. The clouded lens gradually turns yellow-brown, making colours look duller and more yellow. Many patients only notice after surgery how much the colours had shifted — whites look noticeably whiter and bluer afterwards.

Yes, this is a classic complaint. Glare from headlights, halos around light sources and reduced contrast make night driving difficult. It is often one of the first reasons to consider surgery.

We operate when cataract interferes with your daily life, driving or work. There is no longer a 'ripe' moment to wait for — modern techniques allow earlier surgery with a safer and more precise result. You decide together with the ophthalmologist when you are ready.

Yes. Cataract is not an emergency, except in rare cases (e.g. phacomorphic glaucoma). Waiting does not compromise the final result, as long as surgery is not postponed for years until the lens becomes rock hard — the procedure then becomes technically more demanding.

Vision will slowly continue to decline towards severe visual impairment. In the very long term, untreated dense cataract can additionally cause complications such as acute glaucoma (raised intraocular pressure) or intraocular inflammation.

No, there is no upper age limit. Even patients over 90 are operated safely and successfully under topical (drop) anaesthesia. The procedure is short and barely stresses the body.

No. We operate on one eye at a time, usually with a 1- to 4-week interval. This leaves one functional eye during the recovery period, and the outcome of the first eye can refine the calculation for the second.

Usually the more bothersome eye (worst vision or greatest impact on daily life). With equal cataract the dominant eye is often operated first.

Your eye is measured precisely with the IOLMaster 700 (biometry). Corneal topography, macular OCT, refraction, intraocular pressure and retinal examination are also performed. Based on these data, Dr Pinxten determines the optimal IOL type and power.

Biometry is the precise measurement of axial length, corneal curvature and thickness and anterior chamber depth. These data allow exact calculation of the IOL power. We use the Zeiss IOLMaster 700 — the current gold standard.

Yes. Contact lenses temporarily distort the cornea and falsify the measurements. Soft lenses: stop 2 weeks before; toric: 3 weeks; rigid or ortho-K: 4 weeks. This is essential for correct IOL power.

Usually 2 to 6 weeks before surgery. This leaves enough time to order the right IOL and to discuss lens choice, cost and planning calmly.

No. You may eat, drink and take your usual medication. Your pupils may be dilated (for 2-3 hours) so you cannot drive afterwards — arrange a driver or public transport.

An IOL is a small, flexible, transparent implant made of biocompatible material (acrylic) placed during surgery in the location of the removed natural lens. An IOL lasts a lifetime — it does not discolour or cloud and never needs replacement.

Three main categories: (1) monofocal — single sharp focus, usually for distance; (2) comfort or EDOF — extended depth of focus from distance to intermediate (60-80 cm); (3) multifocal — three focal points: distance, intermediate and near. Each type also exists in a toric version to correct astigmatism.

The standard IOL with a single sharp focal point, usually set for distance. You will need reading glasses for near. Monofocal IOLs are fully reimbursed by INAMI/RIZIV and provide excellent sharp vision without visual side effects.

A premium IOL with multiple focal points (distance, intermediate and near) allowing spectacle independence in 80-85% of daily activities. Possible side effects: mild halos and glare around lights at night — usually resolving within a few months through neuroadaptation.

EDOF stands for 'Extended Depth Of Focus'. It provides a continuous sharp range from distance to about 60-80 cm: ideal for dashboard, computer and cooking without glasses. Reading glasses are usually still needed for fine print. Far fewer halos than with multifocal IOLs.

A toric IOL corrects corneal astigmatism. It has an oriented axis and must be placed at the precise rotation during surgery. Available as monofocal, EDOF or multifocal toric versions.

The choice depends on your measurements, lifestyle, profession, hobbies and expectations regarding spectacle independence. Dr Pinxten discusses the options during the pre-operative consultation and recommends the optimal type — the decision is made together.

With a monofocal IOL: reading glasses are needed. With an EDOF: usually no glasses for distance and intermediate. With a multifocal: 80-85% of daily tasks without glasses. No IOL guarantees 100% spectacle independence in all situations.

Yes. The materials (hydrophobic or hydrophilic acrylic) are biocompatible, do not yellow and never need replacement. Years later 'posterior capsule opacification' (PCO) can develop — clouding of the small capsule behind the IOL — which is resolved with a simple YAG laser treatment.

Very rarely. The IOL is placed in the natural lens capsule (capsular bag), where it stays stable. In some eye conditions (pseudoexfoliation, high myopia, trauma) the risk of decentration is slightly higher.

The procedure is performed under topical drop anaesthesia as day surgery. Through 2 mm micro-incisions the cloudy lens is fragmented with phacoemulsification (ultrasound) and aspirated. The folded IOL is then inserted through the same small opening into the capsular bag, where it unfolds.

The procedure itself takes about 10 to 15 minutes per eye. Including preparation (drops, checks, disinfection) and short post-op observation, you spend a total of 2 to 3 hours in the hospital.

The modern standard technique in which the cloudy lens is fragmented by ultrasonic vibrations through a fine probe and simultaneously aspirated. All through a 2 mm incision — no sutures required.

No, under normal circumstances. The 2 mm micro-incisions self-seal through the intraocular pressure. This explains the rapid recovery and minimal discomfort.

Standard cataract surgery uses ultrasound (phaco), not a laser. A 'femto laser cataract' variant exists where the first steps are performed with a femtosecond laser — studies show no significant improvement in the final result compared to standard phaco.

Serious complications are rare (< 1-2%). The most common intra-operative complication is a tear in the posterior capsule, in which case the IOL may need to be placed in two stages or a different IOL type may be required. See also the 'Risks' section.

Very rarely — in case of a large capsular tear or weak zonular support — the IOL cannot be placed immediately. A second procedure a few weeks later (e.g. sulcus or iris-fixated IOL) solves this. The final visual result is generally excellent.

No. The procedure is completely painless. The eye is anaesthetised with drops that act within minutes. You may feel slight pressure and see some light and colour shades, but no pain.

No. With Dr Pinxten anaesthesia is given purely with drops (topical anaesthesia). A retrobulbar or peribulbar injection is only exceptionally required in very anxious patients or complex cases.

No, it is not needed. Cataract surgery is performed under local drop anaesthesia. General anaesthesia is only considered for children, people with severe intellectual disability or patients unable to lie still.

If you are anxious, a light sedative (e.g. Xanax) can be given before the procedure. It is not mandatory — many patients do not need it.

You feel mild pressure and some fluid rinsing the eye. You see the microscope lights on which to fixate, plus vague colour shades and movement, but no sharp image or instruments. Dr Pinxten talks to you throughout the procedure to let you know what will happen or what you will see.

The eye is held open with a small lid speculum. You cannot blink — the anaesthetic drops also suppress the blink reflex. This is comfortable and painless.

Cataract surgery is far more tolerant of eye movement than laser surgery. The surgeon follows the eye with the microscope. You are asked to look at the light as calmly as possible — the ophthalmologist guides you verbally throughout.

Vision often improves within 24 hours. Complete recovery and stabilisation take 4 to 6 weeks. Most patients can resume normal activities after a few days, with a few restrictions around heavy lifting, swimming and eye rubbing.

Many patients already see a clearly brighter and more colourful image the next day. A slight haze or distortion during the first days is normal. The final sharp result with definitive spectacle correction is usually reached after 4 to 6 weeks.

Yes. Cataract is done as day surgery — you spend 2 to 3 hours at the hospital and go home the same day. You cannot drive yourself; arrange a companion or transport.

Usually after 1 to 3 days, following the first check-up. You must see sharply enough (at least 5/10 binocular) and feel comfortable. With dense cataract in both eyes, wait until the second eye has also been operated.

Office or light work: usually after 2 to 5 days. Heavy physical work, dusty environment or contact sport: at least 1 to 2 weeks. For specific professions (welder, miner, firefighter) a longer wait is recommended.

You receive a schedule with antibiotic drops, anti-inflammatory drops (3-4 weeks tapered) and artificial tears if needed. Follow the schedule strictly. This prevents most complications.

At night, wear a transparent eye shield for the first week to avoid unconsciously rubbing the eye during sleep. During the day no patch is needed — regular sunglasses suffice against wind and light.

No. For the first 2 to 4 weeks absolutely not. This can reopen the incision or affect the freshly placed IOL. If itchy: artificial tears or dab gently with a clean tissue.

Yes, from the day after surgery, but make sure no soap or water enters the operated eye directly during the first week. Head slightly back when washing hair.

Swimming pool, sea, sauna and jacuzzi are not advised for at least 2 to 4 weeks after surgery, to avoid infection. Ask the ophthalmologist for confirmation at the check-up.

Walking and cycling after a few days. Jogging and gym after 1 week. Contact sports (football, martial arts) and swimming after 2 to 4 weeks. If in doubt: ask at the check-up.

Eye make-up (mascara, eyeliner, eyeshadow) is not advised for at least 1 week. Afterwards preferably use new, uncontaminated products.

Light bending is fine. Heavy lifting (> 10 kg), straining and intense physical work should be avoided in the first week as this briefly raises intraocular pressure.

Yes, flying poses no risk to the operated eye. Cabin pressure does not affect the IOL or the wound. You can fly a few days after the procedure, taking your eye drops with you.

Usually 2 to 3 check-ups: the day after surgery, sometimes after 1 week, and after 4 to 6 weeks. The final check determines the definitive spectacle prescription if needed.

Cataract surgery is one of the most frequently performed and best standardised procedures in the world (more than 25 million per year worldwide). The success rate exceeds 98%. Serious complications are rare (< 1-2%) and mostly well treatable. Dr Pinxten is highly experienced and operates weekly, which substantially reduces the risk of complications.

Possible complications: posterior capsule tear (1-2%), raised intraocular pressure, inflammation, macular oedema (swelling of the central retina), retinal detachment (rare, especially in high myopia) and endophthalmitis (severe intraocular infection, < 0.05%). All these complications are very rare and most procedures proceed very smoothly.

The risk of severe permanent vision loss is very small — less than 1 in 1000. It can occur with severe intraocular infection (endophthalmitis) or retinal detachment. Rapid treatment usually limits the damage.

A rare but serious intraocular infection (< 0.05%). Symptoms: pain, red eye, sudden vision loss, usually within the first week. Rapid treatment with intraocular antibiotics is crucial. If suspected, immediately call the ophthalmologist or, if unavailable, the AZ Zeno emergency department — an on-call ophthalmologist is always reachable.

PCO is a clouding of the small capsule behind the IOL that can develop months to years after surgery. Vision becomes blurred again. PCO is not a 'return' of cataract and is easily resolved with a YAG laser treatment in the consulting room: painless, a few minutes, definitive.

A YAG laser creates a small opening in the clouded posterior capsule (PCO). The treatment is done in the consulting room, takes 2 to 5 minutes, is painless and vision recovers within a few hours. Once performed, PCO does not return.

The risk is slightly increased, especially in high myopia or with previous retinal problems. Symptoms: sudden flashes, black spots, a curtain or shadow in the visual field. In case of these complaints contact us immediately — rapid treatment is crucial.

Mild inflammation is normal and managed by the anti-inflammatory drops. Severe inflammation is rare. Follow the drop schedule strictly and do not rub the eye.

Thanks to the very precise IOLMaster measurement, the final result is within ± 0.5 dioptre of the target in 95% of cases. If there is a larger deviation, a mild spectacle or contact lens correction may be needed. In rare cases an IOL exchange or laser top-up may be considered.

If the eye is otherwise healthy, the expected vision is excellent — often 10/10 or better. With other eye disease (macular degeneration, diabetic retinopathy, glaucoma) the vision is limited by that condition, not by the cataract surgery.

With a monofocal IOL: reading glasses needed. With an EDOF: usually no glasses for distance and computer, reading glasses for fine print. With a multifocal: 80-85% of situations spectacle-free. In case of astigmatism, a toric version is needed to achieve spectacle independence.

Vision is often much better than you can remember — patients are surprised by the brightness, contrast and blue whites. A few differences with natural vision remain: the IOL does not accommodate for reading (except EDOF/multifocal).

No. The natural lens has been removed and replaced with an unchanging IOL. 'Posterior capsule opacification' can develop years later — clouding of the lens capsule — easily resolved with YAG laser.

A lifetime. The IOL does not degrade, does not yellow and never needs replacement. With PCO a single YAG laser is performed and afterwards the result remains stable.

Yes — strikingly. The clouded natural lens has yellow-browned over the years. After replacement with a clear IOL, colours look brighter and bluer. Many patients notice this immediately: 'white is really white again'.

With a monofocal or EDOF IOL, night-time visual side effects are rarely troublesome. With multifocal IOLs, mild halos or glare can occur, especially in the first 3 to 6 months — they usually fade through neuroadaptation.

The cataract operation itself is largely reimbursed by INAMI/RIZIV. Your out-of-pocket cost is around 200 euros with a standard monofocal IOL. With a premium IOL (multifocal, EDOF, possibly toric) a surcharge applies on top of the base tariff. The exact amount is communicated during the pre-operative consultation.

Yes. INAMI/RIZIV fully reimburses the procedure, surgeon's fees, the standard monofocal IOL, the day hospitalisation and anaesthesia — you only pay the statutory co-payment. Premium IOLs carry a legally accepted surcharge that is borne by you.

The surcharge for a multifocal or EDOF IOL ranges from a few hundred to around 1500 euros per eye, depending on the model. This surcharge covers the premium lens material and additional technology. The exact price depends on the chosen brand and model.

A toric IOL (for astigmatism correction) has a surcharge that varies by model. From about 2 dioptres of astigmatism it is reimbursed for unifocal IOLs. The ophthalmologist determines in advance if it is necessary. With premium IOLs (not reimbursed), a toric version is often used to give the patient the best possible spectacle-free vision after the procedure.

Most hospitalisation insurances do not reimburse premium IOLs. It depends on your policy. Check with your insurer in advance. You receive a detailed cost estimate.

The mutual insurance automatically reimburses the largest part via third-party payment. You only pay the co-payment and any surcharges (premium IOL or single room).

Cataract surgery is performed as day surgery. You stay with six to eight other patients in a collective day-care room. If you wish a single room, indicate this in advance to the ophthalmologist. A room surcharge applies.

Yes. During the pre-operative consultation you receive a clear and transparent overview of all costs: INAMI/RIZIV reimbursement, co-payment, any IOL surcharge and hospital costs. No surprises afterwards.

All Dr Pinxten's procedures take place at AZ Zeno, Blankenberge campus — a modern hospital with a dedicated ophthalmic day surgery unit. Pre-operative work-ups are done at the Knokke practice (Duinenwater) or at AZ Zeno Blankenberge.

The surgical schedule is adapted to your availability. Usually you can be operated within a few weeks of the pre-operative work-up. For a planned second eye, a second date is booked, typically 1 to 4 weeks after the first.

Cataract is performed as day surgery — total duration 2 to 3 hours (preparation + 15-20 min procedure + short observation). You do not stay overnight.

No. As the procedure is performed under drop anaesthesia, you may eat and drink normally beforehand. It is advised not to consume alcohol. Follow the specific instructions from the hospital.

Yes, most medications are simply continued. Blood thinners (Marcoumar, Sintrom, NOACs) usually do NOT need to be stopped for cataract surgery — always discuss this in advance. Bring a complete medication list to the pre-operative work-up.

Yes. On the day of surgery you cannot drive yourself. Arrange a family member, friend or taxi. From the day after the procedure (after the first check-up) you can usually drive again.

ID card, list of your medications and completed questionnaire, hospitalisation insurance details if applicable, glasses/reading glasses if needed, comfortable clothing. No valuables or jewellery. You receive documentation with instructions in advance.

Preferably not — after surgery you cannot drive or cycle yourself. Be brought by family or arrange a taxi.

Dr Pinxten regularly supervises trainees or less experienced colleagues, but this never involves her own patients! For all patients who consult with Dr Pinxten herself, she personally performs all cataract operations: from pre-operative work-up to surgery and even follow-up. Continuity of care is a core value of the practice: you have one fixed contact person.

Cataract is by far the most frequently performed procedure in the practice — several operating days per week. This high volume keeps the technique sharp and complication rates low.

Of course. A second opinion is a good idea for an important decision such as IOL choice or timing of the procedure. We are happy to provide a copy of your measurements if requested.

During office hours, call the practice. For urgent complaints outside hours (sudden pain, sudden decrease in vision, red eye), call the AZ Zeno Blankenberge emergency department directly — the on-call ophthalmology service will be notified.