Cataracts

Question 1

What are cataracts?

Answer 1

It is defined as a condition in which the lens in the eye becomes opacified

Question 2

What is the pathophysiological consequence of cataracts?

Answer 2

There is reduced visual acuity due to less light reaching the retina

Question 3

What is the most common cause of blindness worldwide?

Answer 3

Cataracts

Question 4

What are the four classifications of cataracts?

Answer 4

Nuclear Cataracts

Cortical Cataracts

Posterior Subcapsular Cataracts

Congenital Cataracts

Question 5

What are nuclear cataracts?

Answer 5

They are caused by sclerosis of the lens nucleus and lens refractive index

Question 6

Which patient group tend to be affected by nuclear cataracts?

Answer 6

Elderly

Question 7

What are the two clinical features assoicated with nuclear cataracts?

Answer 7

Myopia

Colour Dullness

Question 8

What are cortical cataracts?

Answer 8

They are caused by opacifications of the lens cortex

Question 9

How do cortical cataracts present on opthalmoscopy?

Answer 9

Spokes of a wheel around the edge of the lens

Question 10

What are posteior subcapsular cataracts?

Answer 10

They are caused by opacifications of posterior aspect of the lens capsule

Question 11

Which patient group tend to be affected by posterior subcapsular catarcts?

Answer 11

Younger Patients Who Are Administered Steroids

Question 12

What is the clincial feature associated with posterior subcapsular cataracts?

Answer 12

Light Glare

Question 13

What are the two risk factors of congential cataracts?

Answer 13

Congenital Rubella Syndrome
Genetic Predisposition

Question 14

When do congential cataracts present?

Answer 14

Newborn Examination

Question 15

What is the feature of congential cataracts on newborn exmination?

Answer 15

Red Reflex Absence

Question 16

How do we manage congential cataract patients? Why?

Answer 16

An urgent referral to ophthalmology to conduct surgery in the first six weeks of life

To prevent amblyopia

Question 17

What is ambylopia?

Answer 17

It is permanent visual loss due to the brain neglecting the eye

Question 18

What are the eight risk factors associated with cataracts?

Answer 18

Increasing Age
Ocular Trauma
Diabetes Mellitus
Hypocalcaemia
UV Exposure
Smoking
Alcoholism
Steroid Administration

Question 19

What is the most common risk factor associated with cataracts?

Answer 19

Increasing Age

Question 20

Do the clinical features of cataracts tend to present unilaterally or bilaterally?

Answer 20

Unilaterally

Question 21

What are the seven clincial features of cataracts?

Answer 21

Reduced Visual Acuity
Progressive Blurred Vision
Light Glare
Light Haloes or ‘Starbursts’
Colour Dullness
Reduced Red Reflex
Clouded Lens

Question 22

What are the two investigations used to diagnose cataracts?

Answer 22

Ophthalmoscope
Slit-Lamp Examination

Question 23

What is the feature of cataracts on opthalmoscope?

Answer 23

A normal fundus and optic nerve

Question 24

What are the two features of cataracts on slit-lamp examination?

Answer 24

Reduced Red Reflex
Clouded Lens

Question 25

When is conservative management recommended to treat cataracts?

Answer 25

In cases where clinical features don’t have an effect on the patient’s quality of life

Question 26

What are the five conservative management options of cataracts?

Answer 26

Stronger Glasses/Contract Lenses Smoking Cessation Steroid Cessation Reduced UV Exposure Diabetes Mellitus Control

Question 27

What is the surgical management option of cataracts?

Answer 27

Phacoemulsification

Question 28

What is phacoemulsification?

Answer 28

It involves breaking the lens into fragments with ultrasound, removal of these fragments and implantation with an artificial lens

Question 29

What is referral for cataract surgery dependent on?

Answer 29

Whether visual impairment is present The impact on quality of life The patient's choice

Question 30

What are the four surgical complications of cataracts?

Answer 30

Posterior Capsule Opacification Endophthalmitis Retinal Detachment Posterior Capsule Rupture

Question 31

How do posterior capsule opacification complications present?

Answer 31

The patients will present with returning clincial features months to years after surgery

Question 32

How do we treat posterior capsule opacification complications?

Answer 32

Capsulotomy

Question 33

What is capsulotomy?

Answer 33

This is when lasers are used to make a hole in the capsule to allow light to pass through

Question 34

What is endopthalmitis?

Answer 34

It is an infection of the queous and/or vitreous humour

Question 35

What are the four clinical features of endopthalmitis?

Answer 35

Retinal Periphlebitis Eye Pain Red Eye Worsening Vision

Question 36

How do we treat endopthalmitis?

Answer 36

Intravitral antibiotic injections

Question 37

What is the pathophysiological consequence of untreated endopthalmitis?

Answer 37

Vision loss