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OPTM5103/5104 > Cataract > Flashcards

Cataract Flashcards

1
Q

Which type/s of cataract is associated with frequent change of glasses and gradual, painless and progressive loss of VA which is do to rapid change in refractive index?

A

Cortical or nuclear

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2
Q

Which type/s of cataract is associated with myopic shift?

A

Nuclear

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3
Q

Which type/s of cataract is associated with being blinded by light by oncoming headlamps when driving?

A

Posterior sub capsular

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4
Q

Which type/s of cataract is associated with monocular diploopia or polyopia?

A

Cortical, spoke or cuneiform

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5
Q

Which type/s of cataract is associated with coloured haloes around light?

A

Cortical

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6
Q

Which type/s of cataract is associated with having a colour shift?

A

Nuclear

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7
Q

Which type/s of cataract is associated with loss of visual field?

A

All types of cataracts

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8
Q

What does an optometrist do to assess indications for cataract surgery?

A
  1. Slit lamp examination
  2. Assessment of impact of visual problems on QOL
  3. Discuss potential benefits and risks of cataract surgery
  4. Ensure appropriate information is included in referral
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9
Q

What outcome measures are looked at post surgery?

A

VA
Colour sensitivity
Colour vision
Glare sensitivity
VF

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10
Q

What is the postoperative follow-up like for cataract surgery?

A
  • Surgeon usually sees patient:
    –> 1 day post surgery
    –> 1 week after surgery
    –> 1 month after surgery
    –> Sometimes 2 months after surgery
  • Opportunity for shared-care with optometrist
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11
Q

Expected post-cataract surgery complications:

A
  • Anisometropia (because of existing high refractive error)
  • Floaters
  • Colour perception changes (one eye will be seeing though a yellow filter while the other may appear clear)
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12
Q

Unplanned complications post-cataract surgery

A
  • Induced cyl due to lens positioning
  • Floaters
  • Distortion of pupil margins
  • Glare
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13
Q

What are some intra-operative complications?

A
  • Posterior capsular rupture
    (increased risk of endophthalmitis by 6x, and retinal detachment by 19x)
  • Dropped nucleus (loss of nuclear material into vitreous cavity)
  • Dropped IOL (loss of IOL into the vitreous cavity)
  • Phaco wound burn
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14
Q

What are some early emergent post-operative complications?

A
  • Ocular hypertension
  • Malignant glaucoma
  • Wound leak with shallow or flat AC
  • Iris prolapse
  • Dislocated IOL
  • Toxic anterior segment syndrome (TAAS)
  • Endophthalmitis (very rare due to the intracameral antibiotics - one of them most severe complications)
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15
Q

What are some less-emergent post-operative complications?

A
  • Would leak with well formed anterior chamber
  • Acute corneal oedema
  • Hyphaema
  • Anterior ischemic optic neuropathy
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16
Q

What are some intermediate to late post-operative complications?

A
  • Dysphotopsias
  • Glaucoma
  • Corneal oedema/decompensation
  • Chronic anterior uveitis
  • Posterior capsular opacity
  • Pseudophakic cystoid macular edema
  • Retinal detachment
17
Q

Indications for posterior capsular opacification treatment

A
  • Symptoms are more important than tests of vision function
    –> blurred vision, glare, reduced contrast
  • Sverity of PCO correlates poorly with high contrast visual acuity
18
Q

Complicatgions of Nd:YAG laser capsultomy for PCO?

A
  • IOP spike within few hours
  • Pseudophakic cystoid macular oedema
  • Subluxation or dislocation of the IOL
  • Intraocular inflammation or endophthalmitis
19
Q

What are pre-operative pharmacotherapy for cataract surgery?

A
  • Mydriatics
  • Prophylactic antibiotics
  • NSAIDs
  • Anaesthetics
20
Q

What are intraoperative pharmacotherapy for cataract surgery?

A
  • Irrigating solutions
  • Ophthalmic viscosurgical devices
  • Intracameral antibiotics
21
Q

What are post-operative pharmacotherapy for cataract surgery?

A
  • Antibiotics
  • Corticosteroids
  • NSAIDs
22
Q

What complciations 4+ weeks post surgery need attention/

A
  • Cells and flare
  • Sudden loss of VA
  • Pain
  • Floaters
  • Photophobia
  • Elevated IOP
  • Flat AC
23
Q
A

OPTM5103/5104 (7 decks)

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