CATARACT

Question 1

1.Cataract?

2.Classification!

Answer 1

Opacification of crystalline lens of an eye.

1.On the basis of age
Congenital
Acquired ….adult,presenile,senile
2.on the basis of location of opacity
Capsular
Subcapsular
Cortical
Nuclear
Lamellar
3.on the basis of degree of maturity
Immature
Mature
Hyper mature
Morgagnian

Question 2

1.Most common type of congenital cataract is…

2.caises of congenital cataract?

3. What is the feature of galactosemia cataract?
4. What are signs and symptoms of cataract?
5. What are DDs of leukocoria?
6. Wilson disease causes which type of cataract?
7. Rosette cataract occurs due to?
8. Most common form of senile cataract is?

Answer 2

1. Lamellar cataract…consists of clear lens fibres within and around it.
2. Congenital rubella
   Maternal exposure to radiation
   Steroids
   Pre eclampsia and eclampsia
   Fetal abnormalities e.g galactosemia, hypoglycemia, hypocalcemia,forceps delivery .

3.central oil droplet cataract.

4.decreased vision,leukocoria,squint and nystagmus.

5.congenital cataract
Retinoblastoma
Persistent hyperplastic primary vitreous.
Coat’s disease
Endopthalmitis

6. Sunflower appearance cataract

7.contusion injury

8.cortical/cuneiform cataract

Question 3

1.A child above 2 years of age has
Unilateral cataract. Which surgery is indicated?

2.in subluxated congenital cataract, chronic anterior uveitis and ectopia lentis which surgery is indicated?

3.Visually significant bilateral cataract surgery should be done before….. weeks

4.Visually significant unilateral cataract surgery should be done before …. weeks bcoz great risk of amblyopia.

5. Hypermetropia shift occurs in which cataract?
6. Myopic shift occurs in which cataract?

Answer 3

1. Lens aspiration and using IOL .
2. Lensectomy.
3. 10 weeks

4.6 weeks

5.cortical cataract

6.nuclear cataract
The lens fibres undergo dehydration causing sclerosis. So refractive index of nucleus increases Causing myopia

Question 4

1. What is the accurate method for diagnosis of cataract?

2.what are the complications of cataract?

3. Toric IOL ?

4.multifocal IOL?

Answer 4

1. Slit lamp examination
2. Phacomorphic glaucoma…swollen lens cause relative pupillary block…fluid accumulation in post chamber…push the iris forward….closure of anterior chamber…rise in IOP
   Phacolytic glaucoma
   Phacoantigenic uveitis
   Dislocation of lens into vitreous or anterior chamber
   Incarceration of pupil

3 have cylindrical as well as spherical power.

4.accomodative lenses …for both near and distant vision.

Question 5

1. What are surgical TTT of cataract?

Answer 5

1. Phacoemulsification
   Extra capsular cataract extraction (removal of lens nucleus and cortex through opening in anterior capsule ,leaving posterior capsule intact in its place.)
   _Indicated when very hard lens is present _
   Intra capsular cataract extraction (Removal of cataract along with its capsule)
   indicated when weak zonules are present and in subluxated or dislocated lens
   Pars plana lensectomy

Question 6

Complications of cataract surgery
1.Anesthetic complications

2.Intraoperative complications

3.Early post op complications

4.Late post op complications

Answer 6

Anesthesia complications
Retrobulbar hemorrhage
Perforation of globe
Cardiac arrest
Respiratory arrest

Intra operative complications
Supra choroidal hemorrhage
Rupture of posterior capsule
Vitreous loss
Nuclear subluxation
Iridocyclitis
hyphaema
Early Post op complications
Endopthalmitis….TTT intravitreal antibiotics inj
Corneal edema
Wound leakage
Secondary glaucoma
Hyphaema
Iridocyclitis
Late post op complications
Chronic endopthalmitis
Phacoantigenic uveitis
CME
RD
Posterior capsule opacification

Question 7

1. Which refractory error is present in aphakia?

2.In aphakic eye which purkinje images are absent?

Answer 7

1. Hypermetropia
2. Purkinje images are reflection of light on lens and cornea. 4 images
   P1 …reflection on outer surface of cornea
   P2…on inner surface
   P3…on outer lens
   P4…on inner lens
   In aphakia,P3 and P4 are absent.