20 - Cataract

Question 1

Cataract

Answer 1

opacity within the lens

• may affect 1 or both eyes
• if present in both eyes, may be worse in 1 than the other

Question 2

cataracts

possible causes

Answer 2

• most are age related
• blunt/penetrating trauma
• smoke
• alcohol
• radiation/UV
• drugs like steroids
• ocular inflammatn
• diabetes (tend to get cataracts at younger age)

Question 3

senile cataract

Answer 3

altered metabolic process w/in lens»> accumltn of water + change in lens fiber structure

Question 4

cataract manifestations

Answer 4

• decr vision
• abnorm color, perception
• glare
• GRADUAL visual decline

Question 5

glare is due to..

Answer 5

light scattered by lens opacities

-worse at night bc pupils dilate

Question 6

opacity is directly observable w…

Answer 6

• ophtolmascope

- slit lamp microscopic examination

Question 7

nonsurgical therapy

Answer 7

• strong reading glasses
• magnifying glass
• increase amt of light
• drive during day instead of night

Question 8

pre-op

Answer 8

• no extensive assessment bc only requires local anesthesia
• NSAID eye drop to reduce inflammation
• dilating drops
• *if pt is getting surgery, especially note the acuity of the non-op eye**

Question 9

2 types of dilating drops

Answer 9

1 MYDRIATIC A-adrenergic agonist
–produce pupillary dilatn by contracting iris dilator muscle
2 CYCLOPLEGIC tropicaide
–anticholinergic> blocks acetylcholine on ciliary body muscle
—produce cycloplegia + mydriasis

Question 10

cycloplegia

Answer 10

paralysis of accomodation

Question 11

cycloplegis + mydriatics

nurse education

Answer 11

• wear dark lense to prevent photophobia

- monitor for signs of toxicity (tachy, CNS effects)

Question 12

most common form of cataract surgery

Answer 12

phacoemulsification

Question 13

phacoemulsification

Answer 13

• v small incision on surface near cornea
• thin ultrasound inserted to emit vibration
• dissolved cloudy into fragments
• then suctioned out
• incision is self healing, no sutures needed

Question 14

extracapsular cataract extraction procedure

Answer 14

• for V advanced cataracts where lens is too dense to dissolve
• larger incision to remove cataract in one piece
• requires sutures

Question 15

most pt have ___ at time of cataract extraction

Answer 15

intraocular lens implantation

Question 16

postop meds

Answer 16

abx> prevent infection

corticosteroid> prevent inflammation

Question 17

post of education

Answer 17

• avoid activities that incr IOP (bend, stoop, cough, lifting valsalva)
• use aseptic technique for eye drops/cleaning
• usually little to no pain but may have scratchy + blurry eyes
• *if pain is intense, contact HCP**
• help w steps, remove area rugs, prep meals before surgery,

Question 18

if wearing a patch….

Answer 18

they will not have depth perception until patch is removed

Question 19

healing

Answer 19

1-2 wks until visual acuity reaches adequate level