Cataracts Flashcards
What are cataracts?
It is defined as a condition in which the lens in the eye becomes opacified
What is the pathophysiological consequence of cataracts?
There is reduced visual acuity due to less light reaching the retina
What is the most common cause of blindness worldwide?
Cataracts
What are the four classifications of cataracts?
Nuclear Cataracts
Cortical Cataracts
Posterior Subcapsular Cataracts
Congenital Cataracts
What are nuclear cataracts?
They are caused by sclerosis of the lens nucleus and lens refractive index
Which patient group tend to be affected by nuclear cataracts?
Elderly
What are the two clinical features assoicated with nuclear cataracts?
Myopia
Colour Dullness
What are cortical cataracts?
They are caused by opacifications of the lens cortex
How do cortical cataracts present on opthalmoscopy?
Spokes of a wheel around the edge of the lens
What are posteior subcapsular cataracts?
They are caused by opacifications of posterior aspect of the lens capsule
Which patient group tend to be affected by posterior subcapsular catarcts?
Younger Patients Who Are Administered Steroids
What is the clincial feature associated with posterior subcapsular cataracts?
Light Glare
What are the two risk factors of congential cataracts?
Congenital Rubella Syndrome
Genetic Predisposition
When do congential cataracts present?
Newborn Examination
What is the feature of congential cataracts on newborn exmination?
Red Reflex Absence
How do we manage congential cataract patients? Why?
An urgent referral to ophthalmology to conduct surgery in the first six weeks of life
To prevent amblyopia
What is ambylopia?
It is permanent visual loss due to the brain neglecting the eye
What are the eight risk factors associated with cataracts?
Increasing Age
Ocular Trauma
Diabetes Mellitus
Hypocalcaemia
UV Exposure
Smoking
Alcoholism
Steroid Administration
What is the most common risk factor associated with cataracts?
Increasing Age
Do the clinical features of cataracts tend to present unilaterally or bilaterally?
Unilaterally
What are the seven clincial features of cataracts?
Reduced Visual Acuity
Progressive Blurred Vision
Light Glare
Light Haloes or ‘Starbursts’
Colour Dullness
Reduced Red Reflex
Clouded Lens
What are the two investigations used to diagnose cataracts?
Ophthalmoscope
Slit-Lamp Examination
What is the feature of cataracts on opthalmoscope?
A normal fundus and optic nerve
What are the two features of cataracts on slit-lamp examination?
Reduced Red Reflex
Clouded Lens
When is conservative management recommended to treat cataracts?
In cases where clinical features don’t have an effect on the patient’s quality of life
What are the five conservative management options of cataracts?
Stronger Glasses/Contract Lenses
Smoking Cessation
Steroid Cessation
Reduced UV Exposure
Diabetes Mellitus Control
What is the surgical management option of cataracts?
Phacoemulsification
What is phacoemulsification?
It involves breaking the lens into fragments with ultrasound, removal of these fragments and implantation with an artificial lens
What is referral for cataract surgery dependent on?
Whether visual impairment is present
The impact on quality of life
The patient’s choice
What are the four surgical complications of cataracts?
Posterior Capsule Opacification
Endophthalmitis
Retinal Detachment
Posterior Capsule Rupture
How do posterior capsule opacification complications present?
The patients will present with returning clincial features months to years after surgery
How do we treat posterior capsule opacification complications?
Capsulotomy
What is capsulotomy?
This is when lasers are used to make a hole in the capsule to allow light to pass through
What is endopthalmitis?
It is an infection of the queous and/or vitreous humour
What are the four clinical features of endopthalmitis?
Retinal Periphlebitis
Eye Pain
Red Eye
Worsening Vision
How do we treat endopthalmitis?
Intravitral antibiotic injections
What is the pathophysiological consequence of untreated endopthalmitis?
Vision loss
