Cataract

Question 1

What is a cataract?

Answer 1

Opacification of the lens of the eye

UV rays absorbed by lens fibres to protect retina - damaged fibres become opaque

Question 2

Change in vision due to cataract

Answer 2

Blurred

Question 3

Causes of cataract

Answer 3

Ageing
Smoking
Increased alcohol consumption
Trauma
Diabetes mellitus
Long term corticosteroids
Radiation exposure
Myotonic dystrophy
Metabolic - hypocalcaemia

Question 4

Symptoms of cataract

Answer 4

Gradual onset reduced vision
Faded colour vision
Glare
Haloes around lights

Question 5

Signs of cataract

Answer 5

Defect in red reflex

Question 6

Investigations of cataract

Answer 6

Ophthalmoscopy with dilated pupil - normal fundus and optic nerve
Slit lamp - visible cataract

Question 7

Classification of cataract

Answer 7

Nuclear - change in lens refractive index
Polar - localised, commonly inherited
Subcapsular - due to steroid use
Dot opacities - common in normal lenses, seen in diabtetes and myotonic dystrophy

Question 8

Management of cataract

Answer 8

Non -surgical 
Stronger prescription of glasses and contact lenses, encourage use of bright light
Surgical 
Artificial lens
- impairment, failure to correct
-impact on quality of life
- patient choice

Question 9

Complications of cataract surgery

Answer 9

Posterior capsule opacification - thickening of the lens
Retinal detachment
Posterior capsule rupture
Endophthalmitis - inflammation of vitreous and aqueous humor
Phaco burn