Cataract

Question 1

What are cataracts?

Answer 1

Clouding of the lens which leads to decrease in visual acuity and increase glare symptoms

Question 2

What is leukocoria?

Answer 2

It is a sign (not a diagnosis) of a white pupil. It may be noted grossly or via ophthalmoscope with a lack of red reflex.

Question 3

Leukocoria found in adult usually suggests…?

Answer 3

Cataract

Question 4

Leukocoria found in children usually suggests…?

Answer 4

Medical emergency. DDx: retinoblastoma, congenital cataract, retinal malformation, retinal detachment, intraocular infection

Question 5

List the causes of cataracts

Answer 5

a. Congenital
b. Senile (increasing age)
c. trauma: heat, direct
d. radiation: uv
e. corticosteroids; quitiapine
f. atopic dermatitis, eczema

Question 6

What are the causes of congenital cataract?

Answer 6

1/3 hereditary, 1/3 infection or congenital syndrome (e.g. Down) and 1/3 idiopathic

Question 7

What are infectious causes of congenital cataract?

Answer 7

Usually via vertical transmission from mother: 
TORCH
Toxoplasmosis
Other: Syphilis, Parvovirus B19
Rubella
CMV
HSV, HIV

Question 8

Sx of congenital cataract?

Answer 8

Leukocoria or absent red reflex (unilateral or bilateral); nystagmus

Question 9

Dx of congenital cataract?

Answer 9

Slit lamp

Dilated fundoscopic exam

Question 10

Rx of congenital cataract?

Answer 10

Surgical removal within

Question 11

Complications of not treating congenital cataract

Answer 11

Deprivation amblyopia (lazy eye) - improper connection from eye to visual cortex
Strabismus: misalignment of eyes
Blindness

Question 12

Senile cataract is the leading cause of ….?

Answer 12

Blindness. Cataracts are reversible but as mature cataract (severe progression of cataract) remains, the lens begins to irreversible thicken (becomes hyper-mature and lens changes shape)

Question 13

Risk factors of senile cataracts?

Answer 13

Increasing age

Modifiable: smoking, HTN, DM, hyperlipidaemia

Question 14

Sx of senile cataracts?

Answer 14

• Visual impairment
• Leukocoria
• Glare or halos (especially in lit rooms, or driving with car/street lamps)
• Yellowing of vision
• Myopic shift (lens become more convex and become short sighted/adjust long sightedness from presbyopia)

Question 15

Dx of senile cataracts?

Answer 15

Can be detected in opthal exam but must be referred to opthalmologist for slit lamp exam

Question 16

Rx of senile cataracts?

Answer 16

Cataract surgery: phacoemulsification with implantation of intraocular lens (IOL)
90% of adults have increased visual acuity after surgery