Cataracts

Question 1

What is a cataract?

Answer 1

Occurs when the lens in the eye becomes cloudy and opaque, this reduces the visual acuity by reducing the amount of light which can enter the eye.

Question 2

What is the job of the lens?

Answer 2

The job of the lens is to focus light coming into the eye on to the retina at the back of the eye, it is held in place by the suspensory ligament attached to the ciliary body, the ciliary body contracts and relaxes to focus the kens

Question 3

How is the lens held in place and how does it change shape?

Answer 3

The lens is held in place by the suspensory ligaments attached to the ciliary body, the ciliary body contracts and relaxes to focus the lens
When the ciliary body contracts it releases tension on the suspensory ligaments and the lens thicken
When the ciliary body relaxes it increases tension in the suspensory ligaments and the lens thickens
The lens is nourished by the surrounding fluid and doesn’t have a blood supply
The lens grows and develops throughout lofe.

Question 4

How are congenital cataracts screened for?

Answer 4

Red reflex

Question 5

What are the risk factors for cataracts?

Answer 5

Increasing age 
Smoking 
Alcohol
Diabetes
Steroids 
Hypocalcaemia

Question 6

What is the presentation of cataracts?

Answer 6

Symptoms are usually asymmetrical as both eyes are affected separately.
Very slow reduction in vision
Progressive blurring of vision
Change of colour of vision with colours becoming more brown or yellow
Starbursts can appear around lights, particularly at night time

Question 7

What are the different presentations for glaucoma, cataracts and macular degeneration?

Answer 7

Glaucoma= peripheral loss of vision with halos around lights
Macular degeneration= central loss of vision with a crooked or wavy appearance to straight lines
Cataracts= generalised reduction in visual acuity with starbursts around lights

Question 8

What is the management for cataracts?

Answer 8

Drilling and breaking the lens into pieces, removing the pieces and then implanting an artificial lens into the eye
It is usually done as a day case under local anaesthetic.

But if its not causing much bother then you can take a conservative approach and not intervene.

Question 9

What is the serious complication of cataract surgery?

Answer 9

Endopthalmitis= rare but serious complication
It is inflammation of the inner contents of the eye and is usually caused by infection. It can be treated with intravitreal abx injected into the eye (loss of vision and loss of eye itself)