[Sportschosun Jang Jong-ho] Cataracts, macular degeneration and diabetic retinopathy are among the most common eye diseases in older adults.
All three conditions become more common with age, so it is not unusual for them to be found in the same patient. For that reason, many patients worry that retinal diseases such as macular degeneration or diabetic retinopathy may bring on cataracts sooner.
However, there is still no clear evidence that macular degeneration itself directly causes cataracts.
Diabetes, the underlying cause of diabetic retinopathy, is known to affect the onset and progression of cataracts. In addition, patients who have undergone retinal surgery such as vitrectomy may experience faster cataract progression afterward, making follow-up care after surgery important.
◇Senile cataracts up 33% in 10 years... macular degeneration surges more than threefold
According to statistics from the Health Insurance Review & Assessment Service (HIRA), about 1.21 million patients received treatment for senile cataracts in 2024, a 33% increase over the past decade. Over the same period, macular degeneration rose from about 150,000 patients to 570,000, while diabetic retinopathy increased from about 300,000 to 390,000. Macular degeneration showed the sharpest growth, with patient numbers more than tripling in 10 years.
Cataracts are a condition in which the lens becomes cloudy due to aging and other factors, causing blurred vision. Retinal diseases include several types, most notably macular degeneration, which reduces vision when abnormalities develop in the macula at the center of the retina, and diabetic retinopathy, in which diabetes damages the retinal blood vessels.
All three diseases mainly affect older adults. In 2024, people aged 60 or older accounted for 89% of senile cataract patients, 85% of macular degeneration patients and 73.5% of diabetic retinopathy patients.
Because most patients with these conditions are elderly, it is not uncommon for more than one to be found in the same person. In particular, macular degeneration is often diagnosed alongside cataracts, but no direct causal relationship between the two has yet been clearly established. Even when they appear together, it is more appropriate to view this as a result of their shared link to aging.
Patients with diabetes, however, should be especially careful. Chronic high blood sugar can affect retinal blood vessels and lead to diabetic retinopathy, while also influencing lens metabolism and protein changes that may contribute to the onset and progression of cataracts. People with diabetes also tend to develop cataracts at a younger age or see them progress more quickly, making regular checkups important.
◇The retina must be accurately assessed before cataract surgery
When a patient has both a retinal disease and cataracts, treatment plans must be made more carefully. In particular, after retinal surgery such as vitrectomy, cataracts may progress more quickly, so doctors should monitor the condition and decide when cataract surgery is needed. If the cataract is already advanced, retinal surgery and cataract surgery may sometimes be performed at the same time.
On the other hand, even after cataract surgery, vision may not recover as much as expected depending on the condition of the retina, and additional retinal treatment may be necessary depending on the type and severity of the disease. That is why it is important to accurately evaluate the retina before surgery and establish an appropriate treatment plan.
Kim Ye-ji, a retinal specialist at Kim's Eye Hospital, explained, "In fact, cataracts and retinal diseases are often found together, but this can be seen as the result of their shared link to aging. So far, there is still no clear evidence that macular degeneration directly causes cataracts." She added, "However, if a patient has diabetes or has undergone retinal surgery such as vitrectomy, cataract progression may be affected, so it is important to keep checking eye health through regular ophthalmic examinations."
Jang Jong-ho, bellho@sportschosun.com
