Cataracts

Question 1

Define Cataracts

Answer 1

Opacification of the crystalline lens resulting from the normal ageing process, trauma, metabolic disorders (hereditary or acquired), medications or congenital problems

Question 2

Aetiology of cataracts

Answer 2

Normal ageing process = most common cause
Metabolic/hereditary conditions e.g. galactosaemia, Wilson’s, Marfan’s, myotonic dystrophy
Infections e.g. rubella
Congenital problems
Medications
Smoking
Exposure to UV

Question 3

Risk factors for cataracts

Answer 3

Age >65 
Smoking
Long term UV exposure 
Diabetes mellitus 
Eye trauma 
Long-term corticosteroid use 
Family history of congenital cataract or congenital influences 
Uveitis

Question 4

Epidemiology of Cataracts

Answer 4

Accounts for 51% of reversible blindness worldwide
Age-related cataracts are the most common
Cataract surgery is the most frequently undertaken surgical procedure in the NHS

Question 5

Symptoms of Cataracts

Answer 5

Blurred or cloudy vision, even with full correction
Glare, especially driving at night
Washed-out colour vision (Nuclear cataracts)
- Yellowish hue to the cataract
- Reduced richness in colours, especially blues
Disruption in activities of daily living

Question 6

Signs of Cataracts on examination

Answer 6

Reduced visual acuity
Defects in red reflex
Inadequate glasses prescription

Question 7

Investigations for cataracts

Answer 7

Dilated fundus examination: normal
Measurement of intra-ocular pressure: normal
Glare vision test: reduced visual acuity under glare stress
Slit lamp examination of the anterior chamber: cataract visible
Assessment of best visual potential: before cataract surgery