CATARACT IN ENGLISH

                                                     

                                               CATARACT IN ENGLISH

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CATARACT-

•        A cataract is defined as a lens opacity or cloudiness. Cataracts is a leading cause of disability (visual) in older adults.

CAUSATIVE FACTORS-

•        Most cataracts are age related (senile cataracts) but some cataracts are   associated with other factors such as-

•        Blunt or penetrating trauma

•        Congenital factors such as maternal rubella,

•        Radiation or ultraviolet (UV) light exposure

•        As a side effect of certain drugs such as systemic corticosteroids or long-term topical corticosteroids.

•        Ocular inflammations such as Retinitis pigmentosa

•        The patient with diabetes mellitus may also tends to develop cataracts at a younger age.

CLINICAL MANIFESTATIONS

•        The patient with cataracts may complain of

•        A decrease in vision,

•        Abnormal color perception, and glare.

•        Glare is due to light scatter caused by the lens opacities  and it may be significantly worse at night when the pupil dilates.

TYPES OF CATARACT-

•        Main clinical types of cataract are three

•        A nuclear cataract 

•        A cortical cataract 

•        A Posterior sub capsular cataract 

•        A nuclear cataract is caused by central opacity in the lens and has a substantial genetic component. It is associated with myopia, which worsens when the cataract progresses. If dense, the cataract severely blurs vision

•        A cortical cataract involves the anterior, posterior, or equatorial cortex of the lens. A cataract in the equator or periphery of the cortex does not interfere with the passage of light through the center of the lens and has little effect on vision.

•        Posterior subcapsular cataracts occur in front of the posterior capsule. This type typically develops in younger people and, in some cases, is associated with prolonged corticosteroid use, diabetes, or ocular trauma.

DIAGNOSTIC INVESTIGATIONS-

•        Decreased visual acuity is directly proportionate to cataract density. The Snellen visual acuity test, ophthalmoscopy, and slit-lamp biomicroscopic examination are used to establish the degree of cataract formation.

TREATMENT

•        No Medical management (medications, eyedrops, eyeglasses)  can cure   or prevent  cataracts.

•        Surgical management is done to improve vision. Surgery is performed on an outpatient basis and usually takes less than 1 hour, with the patient being discharged in 30 minutes or less afterward.

•        When both eyes have cataracts, one eye is treated first, with at least several weeks, preferably months, separating the two procedures. 

•        This system gives time for the patient and the surgeon to evaluate whether the results from the first surgery are adequate or not

•        Phacoemulsification-

•        In this method of extracapsular cataract surgery, a portion of the anterior capsule is removed, allowing extraction of the lens nucleus and cortex while the posterior capsule and zonular support are left intact. 

•        An intact zonular–capsular diaphragm provides the needed safe anchor for the posterior chamber intraocular lens (IOL).

•        Before discharge, the patient receives verbal and written instructions about how to protect the eye and provide care.

•        The nurse instructs the patient and family in applying and caring for the eye shield.

•         Sunglasses should be worn while outdoors during the day because the eye is sensitive to light.

•        The eye patch/shield is removed after the first follow-up appointment.

•        The patient may experience blurring of vision for several days to weeks.

•        Vision gradually improves as the eye heals. Patients with IOL implants have functional vision even on the first day after surgery