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THE TREATMENT REGISTRY
Patient journey

Cataracts

By The Treatment Registry editors

Clouding of the natural lens of the eye, most commonly age-related but also occurring after trauma, with diabetes, with prolonged steroid use, or congenitally. Cataracts produce gradually worsening blurred vision, glare sensitivity, and difficulty with night driving. Treatment is overwhelmingly surgical (phacoemulsification with intraocular lens implantation); there is no effective non-surgical treatment for established cataracts.

Treatment ladder

Conservative options are first-line where appropriate; surgical options are typically reserved for cases where lower-tier options are unsuitable or have failed. Decisions are individual and depend on clinical assessment.

Conservative

  • Updated spectacle prescription

    May provide modest improvement in early cataracts but does not halt progression. First-line for symptomatic patients not yet at surgical threshold.

  • Brighter lighting and anti-glare strategies

    Practical mitigation for early cataract symptoms; not disease-modifying.

Procedural

  • Phacoemulsification with IOL implantation

    Standard cataract surgery: ultrasonic fragmentation of the cataractous lens and aspiration through a small incision, followed by implantation of an intraocular lens (monofocal, multifocal, or toric). Outpatient procedure under topical anaesthesia. The most commonly performed surgical procedure worldwide.

  • Femtosecond laser-assisted cataract surgery (FLACS)

    Femtosecond laser performs the corneal incision, capsulotomy, and initial lens fragmentation. Theoretical precision advantages; comparative outcome data with conventional phacoemulsification remain mixed.

Surgical

  • Extracapsular cataract extraction (ECCE) — for dense/complex cataracts

    Larger-incision removal of the lens nucleus in one piece. Reserved for very dense cataracts unsuitable for phacoemulsification, or in resource-limited settings.