Cataracts

Question 1

What are cataracts?

Answer 1

Common eye condition where the lens of the eye gradually opacifies (cloudy)–> reduced/blurred vision

Acataract is characterized by an opacity in the lens, which is typically caused by the denaturation of lens proteins. Although primarily prevalent among the elderly, cataracts can also be congenital.

Question 2

Who gets cataracts?

Answer 2

More common in women than men
Incidence increases with age

Question 3

Causes of cataracts?

Answer 3

Normal ageing process- MOST COMMON

Other causes:
Smoking
increased alcohol consumption
Trauma
DM
Long-term corticosteroids
Radiation exposure
Myotonic dystropy
Metabolic disorders e.g. hypocalcaemia

Question 4

Presentation of cataracts?

Answer 4

Gradual onset of:
Reduced vision
Fades colour vision- hard to distinguish
Glare
Halos around lights

Question 5

Signs in a pt with cataracts?

Answer 5

Defect in red reflex. Cataracts prevent light getting to the retina–> defect

Question 6

What is the red reflex?

Answer 6

Reddish- orange reflection seen through an ophthalmoscope when light in shone on the retina.

Question 7

Investigations for cataracts?

Answer 7

Ophthalmoscopy: done after pupil dilation. Findings:normal fundus and optic nerve

Slit- lamp examination: visible cataracts

Question 8

Classification of cataracts?

Answer 8

Nuclear: change lens refractive index, common in old age
Polar: localized, commonly inherited, lie in the visual axis
Subcapsular: due to steroid use, just deep to the lens capsule, in the visual axis
Dot opacities: common in normal lenses, also seen in diabetes and myotonic dystrophy

Question 9

Management of cataracts?

Answer 9

Non-surgical:
Early stages- age-related cataracts can be managed conservatively by prescribing stronger glasses/contacts or by encouraging brighter lighting- will slow the progression

Surgical: only effective treatment for cataracts.
Removing cloudy lens and replacing it with an artificial one

Question 10

What information do you need to give patients surrounding cataract surgery?

Answer 10

Prior: Information on refractive implications of various types of intraocular lenses

After: Patients should be advised on the use of eye drops and eyewear,, what to do if vision changes and the management of any other ocular problems.

Question 11

What are the complications following cataract surgery?

Answer 11

Posterior capsule opacification: thickening of the lens capsule

Retinal detachment
Posterior capsule rupture
Endophthalmitis: inflammation of aqueous and/or vitreous humour