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Eye Disease > Cataract - Optometric management, and surgical management + complications > Flashcards

Cataract - Optometric management, and surgical management + complications Flashcards

1
Q

What is the most common cataract ?

A

Nuclear sclerotic cataract

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2
Q

What rx shift would someone with a NS cataract have?

A

More myopic

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3
Q

What were the number of cataract cases world wide by 2020?

A

30 mil

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4
Q

What percentage of the population over 65 have cataract ?

A

30%

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5
Q

What are 7 traumatic causes of cataract apart from age?

A
  • Blunt trauma
  • Penetrating injuries
  • Concussion
  • Infrared radiation
  • Electric shock
  • Ionizing radiation
  • Post surgery
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6
Q

What type of cataract is this?

A

Traumatic cataract

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7
Q

What are some metabolic causes of cataract ?

A
  • DM
  • Hypoglycaemia
  • Galactokinase deficiency
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8
Q

What are some other causes of cataract?

A
  • Corticosteroids
  • Secondary from anterior uveitis
  • High myopia
  • Rubella
  • Down’s syndrome
  • Myotonic dystrophy
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9
Q

What cataract is this ?

A

Polychromatic “Christmas tree’” cataract

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10
Q

Will a Christmas tree cataract always affect VAs?

A

No but may cause glare

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11
Q

What happens if you do not treat cataract ?

A

Nucleus becomes dark and cortex becomes soft

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12
Q

How would you examine the retina with a cataract that has got to this extent ?

A

Ultrasound

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13
Q

What cataract is this ?

A

End-stage cataract

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14
Q

What is Phacolytic glaucoma ?

A

End-stage Cataract Begins to breakdown inside the eye, then erodes, pressure goes up

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15
Q

What system is used to grade cataract ?

A

LOCS grading

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16
Q

What does the scale go up to for LOCS?

A

0.1-5.9, in practice we normally can just grade it medium, mild, marked ect

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17
Q

What will px with PSC complain of?

A

Glare when driving at night

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18
Q

How did WHO simplify the grading system?

A

Split it into 3 grade system

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19
Q

What is the Oculus Pentacam scanner ?

A

Scans the anterior pole using densitometry trace

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20
Q

What are some sx a px may complain of ?

A
  • Light scatter
  • glare
  • Struggle driving at night
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21
Q

What is back scatter ?

A

Net curtain effect
(idk how to type it btu ask anisha to explain it because it is interesting)

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22
Q

Is there a 6/12 cut off for px to be referred with cataract ?

A

No- not anymore

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23
Q

What is couching?

A

An older technique involving a long sharp needle through the limbus and the opaque lens is the pushed through into the vitreous cavity

24
Q

What is intra-capsular cryo-extraction?

A

What was done before Phacoemulsification, pulling out the whole lens using a big incision including the capsule

25
Q

What is extra-capsular lens expression?

A

Making a gap or hole in the capsule and squeezing the nucleus out

26
Q

What surgery is done now to remove a cataract ?

A

Phacoemulsification Surgery

27
Q

What size incisions are used in Phacoemulsification Surgery ?

A

2mm

28
Q

Do you need stitches in Phacoemulsification Surgery ?

A

No

29
Q

What are five advantages of Phacoemulsification ?

A
  • Minimally invasive
  • Rapid visual rehabilitation
  • Single post-op out px visit
  • No stitches
  • You can prescribe reading specs are 1month post op
30
Q

How does a Phacoemulsification probe work ?

A

Uses high frequency oscillations to emulsify particles and sucks it all up

31
Q

What does capsulorphexis mean?

A

Tearing the capsule, you create a circular gap in anterior capsule

32
Q

Do you know the Phacoemulsification process?

A
33
Q

What is the main Phacoemulsification Complications during surgery?

A

Posterior capsular Rupture where they have managed to go through posterior capsule and the vitreous comes forward

34
Q

What is a very common post Phacoemulsification sugary complication ?

A

Posterior capsular opacification (PCO)

35
Q

How can can posterior capsular opacification be treated?

A

YAG laser posterior capsulotomy

36
Q

What % of children who have had cataract surgery will get PCO?

A

100%

37
Q

What is a complication post-cataract surgery regarding the retina ?

A

Cystic macula oedema, also known as Irvine-Gas syndrome

38
Q

What sx would a px with Irvine-Gass syndrome have?

A

Reduce VAs

39
Q

How is macula oedema post cataract surgery resolved?

A

Spontaneously self limiting but can be healed quicker by using steroids

40
Q

What is the name of the infection you can get post cataract surgery?

A

Endophthalmitis - VERY SERIOUS

41
Q

What is the most common organism that causes endophthalmitis ?

A

Staphylococcus

42
Q

What is the prevalence of RD post cataract ?

A

1/300

43
Q

If you cannot see the capsule because the cataract is that bad, what do you stain it with?

A

Trypan blue

44
Q

Is Phacoemulsification done under general or local anaesthetic?

A

Local

45
Q

What does phakodonesis mean?

A

Mobile lens, moves about a lot so cannot do Phacoemulsification

46
Q

As we cannot do Phacoemulsification On a phakodonesis lens, what do we do?

A

Remove the whole lens

47
Q

What is aniridia ?

A

Iris damage

48
Q

What are some things they can do to correct astigmatism during Phacoemulsification Surgery?

A
  • Limbal relaxing incisions
  • lasek or lasik
  • Astigmatic IOLs
  • Astigmatic keratotomy
49
Q

What is astigmatic keratotomy ?

A

Incisions are put in the cornea to try and change to shape of the cornea

50
Q

Which px have a greater chance of getting RD post cataract surgery ? And why?

A

High myopes because deeper AC, weaker zonules

51
Q

Why are high hypermetropia px difficult to perform Phacoemulsification On?

A

Smaller eye, shallow AC, bulging eyes

52
Q

Why would a multiple lens implant (piggy back lens) be used?

A

Increase refractive power of the lens if they require this correction

53
Q

What is photodisruption ?

A

Modern approach to cataract surgery - uses a laser to cut up tissues & used to for capsulotomy (making an incision in the capsule)

54
Q

What is an advantage of photo disruption?

A

Very accurate incisions made, time effective, you are left with a perfectly round capsulotomy

55
Q

What laser is used to soften a cataract ?

A

Femto-laser, will be easier to remove cataract with Phacoemulsification

Eye Disease (48 decks)

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