Everything about cataract

Intorduction

Cataracts is known as opacification of the lens of the eye.It is major cause of treatable blindness worldwide.

What cause cataract ?

Majority of cases of cataracts are idiopathic age related ( senile cataract ). Numerous secondary causes include local causes such as previous eye trauma, uveitis and intraocular tumour. Systemic causes include diabetes mellitus,metabolic disorder that include, galactosaemia, hypocalcemia, Wilson's disease or skin disease such as atopic dermatitis and scleroderma, drugs ( steroid), X ray and UV radiation , myotonic dystrophic and finally genetic syndrome ( Down's syndrome). Congenital case include congenital rubella syndrome.

How does cataract present ?

Cataract present with gradual onset of painless loss of vision.Present with glare form bright light, vision may worsen in bright light, ( especially with central lens opacity ).Some may experience monoocular diplopia ( double vision in one eye ) and see haloes around lights. Some may notice that they can read without glasses ( nuclear sclerotic cataract may increase lens converging power). In infants may present with lazy eyes or nystagmus.

On examination with opthalmoscope may shows the absence of red reflex and hazy lens appearance. There will be a reduction of visual acuity.

What is the pathology behind cataract

By using slit lamp microscope in the early stages, there is a compression of lens fibers in the central position of the lens ( nuclear sclerosis ) with gradual change of the crystalline lens nucleus from translucent to brown or gray. There may be areas of granular opacification .

How to investigate cataract ?

Unnecessary unless occuring at an early age or in a background of systemic disease.

How to manage cataract ?

Congenital cataract s must be treated urgently to avoid ambylopia. The decision for surgery depends on the effect of the cataract on the patient 's vision and life.

Surgical procedure known as phacoemulsification ( using ultrasound probe ) followed by aspiration of lens material and insertion of intraocular lens implant is curative. Specific complications include posterior capsule opacification, vitreous humour loss and endopthalmitis. Usually done as day surgery. Post op care should include steroid drops ( for inflammation ), antibiotic drops,( infection prophylaxis) and avoidance of strenuous exercise and ocular trauma.

What is the complication and prognosis ?

The complication is none other than reduced quality of life from reduced visual acuity and the prognosis is good with treatment for age related cataracts.

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