cataracts

Question 1

what is cataract

Answer 1

cloudy area in the lens

This cloudiness makes it more difficult for light to reach the back of the eye (retina), thus causing reduced/blurred vision. Cataracts are the leading cause of curable blindness worldwide.

49-51%v

Question 2

types of cataracts

Answer 2

age-related

after an eye injury or after surgery for another eye problem

Question 3

symptoms of cataracts

Answer 3

Your vision is cloudy or blurry

Colors look faded

You can’t see well at night

Lamps, sunlight, or headlights seem too bright

You see a halo around lights

glares - lights appear brighter than usual

You see double (this sometimes goes away as the cataract gets bigger)

You have to change the prescription for your glasses often - reduced refraction

Question 4

risk factors for cataracts

Answer 4

• age
• diabetes mellitus
• Smoke
• Drink too much alcohol
• Have a family history of cataracts
• Radiation exposure
• Myotonic dystrophy
• Metabolic disorders: hypocalcaemia
  Have had an eye injury, eye surgery, or radiation treatment on your upper body
  Have spent a lot of time in the sun
  Take steroids (medicines used to treat a variety of health problems, like arthritis and rashes)

Question 5

Mx for cataracts before surgery

Answer 5

Use brighter lights at home or work

Wear anti-glare sunglasses

Use magnifying lenses for reading and other activities

new glasses or contacts

Question 6

signs of cataracts

Answer 6

A Defect in the red reflex: the red reflex is essentially the reddish-orange reflection seen through an ophthalmoscope when a light is shone on the retina. Cataracts will prevent light from getting to the retina, hence you see a defect in the red reflex.

Question 7

Ix for cataracts

Answer 7

Ophthalmoscopy: done after pupil dilation. Findings: normal fundus and optic nerve
Slit-lamp examination. Findings: visible cataract

Question 8

classification of catracts

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

non surgical management for cataracts

Answer 9

In the early stages, age-related cataracts can be managed conservatively by prescribing stronger glasses/contact lens, or by encouraging the use of brighter lighting. These options help optimise vision but do not actually slow down the progression of cataracts, therefore surgery will eventually be needed.

Question 10

surgical methods for cataracts

Answer 10

phaecoemulsification - most common
manual extracapsulae cataract extraction

local anaesthetic -> awake
involves entering the eye through the cornea + breaking the lens which is sucked and new lens are placed

when vision is worse than 6/12
affects reading/daily life

After cataract surgery, patients should be advised on the use of eye drops and eyewear, what to do if vision changes and the management of other ocular problems. Cataract surgery has a high success rate with 85-90% of patients achieving 6/12 corrected vision (on a Snellen chart) postoperatively.

Question 11

complications following surgery

Answer 11

• Posterior capsule opacification: thickening of the lens capsule
• Retinal detachment
• Posterior capsule rupture
• Endophthalmitis: inflammation of aqueous and/or vitreous humour