Cataracts and IOL Flashcards
(23 cards)
Cataracts
clpudy opacifications of lens
causes loss of accomodation during to hardening of lens
symptoms
Foggy / misty
blurry
colour vision imparied
hazy and glare increased
mono diplopia
problem with DV, NV or both
myopic shifts
dazzle with night lights
Questions to ask px
if affecting ditance or near
similar in bth eyes or one eye worse
amblyopia
mono/binocular vision
diplopia or squint
exams to do
all normal checks
VA
Dilation to see cats
photo and oct
catraracts causes
age related cataracts
traumatic - serious eye injuries, blunt trauma, RTA can cause damage to lens
surgucal trauma
radiation cats
secondary cats
congenical cats
Traumatic cats
affect younger age groups
likely to be associated with other issues such as zonular and iris damage
high risk of retinal detachment
Diabetic cats
Caused when aqueous if filled with gluecose and can diffuse into lens
can cause acclerated age related cataracts
myopic dystrophies
90% of fine cortical cataracts are thrid degreee
affect vision by the 5th decade as satellate posterior capsular cataracts
atopic dermatitis
10% of severe diseases develop cataracts in second to 4th decade
neurofibromatosis
60 percent of px dev cats
cause posterior subcapsular or cortical cats
christmas tree cats
myotonoic dystrophies type 1 (16%) 35-50 acrage age
asscoaited hyperaemia
meds that can cause cats
anterior subcapsular - amioderone and phenothiazine
posterior subcapsular - cortical sterods and chronic alcohol abuse
cortical cats - cholesterol loweing stastins
Congenital cats
occur due to problems durring development
Bilateral and assymetrical
mostly assymptomatic but can cause:-
- Mild amblyopia
- increase in glare
px will rquire surgery earlier in life due to incresed development of cats
Pharmacomorphic cats
when dense cats swell and push forward on iris
this will increase pressure in anterior chamber and can cause acute angle closer glaucoma
treatment:-
- immediate cats surgery in order to prevent blind painful eye
Cats co pathology risks anterior
blepth
cause delayed healing
dry eye 6-12 m post op
chalazion and hordeolum
lids: entropion / ectropion
Cats co pathology risks cornea
fuchs endothelial dystrophies
scarring can make surgery more difficult
band keratopathy esp if over visual axis, may need treated superficially prior to treatment
Cats co pathology risks iris
pseudoexfoliation - cause glaucoma
durring cats surgert causes poor dilation and fragile iris and zonules
will result in px requiring anterior veractomy
flopy iris syndrome
Cats co pathology risks posterior
Diabetes:-
- high risk / poor dilation / iris trauma
- diabetic retinopathy
- increased risk of maculopathy
- delayed healing
Glaucoma:-
- increased IOP durring surgery
- risk of VF loss
AMRD
Floaters
Pre op complications
problems with corneal incision
iris prolapse and trauma
cracks, iol optics
Ealry post op complications
corneal abrasion
corneal oedema
wound leak
vitreous in AC
endopthalmitis
raised IOP
hyphaemia
lens dislocation
retinal lens material
Late post op complications
chronic inflammation
cystoid macular oedema
posterior capsular opacifications
retinal detachment
dysphatopsia
Types of IOL
Mono focal
toric IOL
multifocal IOL
EDOF
multifocal IOL can potentially reduce need for nar vision glasses but are not for anyone
What to include in cats referral
px symptoms
visual difficulties and symptoms
clinical findings:-
- Ref and VA
- Prev best correction
- Prev ocular health
- type of cats
