Cataracts

Question 1

Cataract is a common eye condition where the proteins in the lens of the eye gradually opacifies (clump) together), becoming cloudy and causing cloudy vision. What is the incidence of cataracts?

1 - 5300 cases per 100,000
2 - 530 cases per 100,000
3 - 53 cases per 100,000
4 - 5.3 cases per 100,000

Answer 1

2 - 530 cases per 100,000

Equally as common in men and women

Question 2

Cataract is a common eye condition where the proteins in the lens of the eye gradually opacifies (clump) together), becoming cloudy and causing cloudy vision. What age does the incidence of cataracts peak in?

1 - 70
2 - 60
3 - 50
4 - 40

Answer 2

1 - 70

Question 3

Cataracts can be present at birth, called congenital cataracts. Which of the genetic conditions is NOT typically associated with congenital cataracts?

1 - Trisomy (down syndrome)
2 - T1DM
3 - Wilsons disease
4 - Myotonic dystrophy

Answer 3

2 - T1DM

Question 4

Cataracts can be present at birth, called congenital cataracts. Which 2 of the following congenital infections has been linked withc ongenital cataracts?

1 - toxoplasmosis
2 - mumps
3 - rubella
4 - hepatitis B

Answer 4

1 - toxoplasmosis
3 - rubella

Question 5

Cataracts can also be acquired. All of the following have been identified as potential causes of cataracts. But which is the most common cause?

1 - Smoking
2 - Chronic ocular conditions (uveitis)
3 - Trauma
4 - Physiological ageing
5 - Diabetes mellitus
6 - Long-term corticosteroids

Answer 5

4 - Physiological ageing

Question 6

There are 4 main classifications of cataracts:

• nuclear
• index
• subscapular
• dot opacities

Which of these matches the following:

• common in normal lenses
  -also seen in diabetes and myotonic dystrophy

Nuclear: change lens refractive index, common in old age
Polar: localized, commonly inherited, lie in the visual axis
Subcapsular: due to steroid use, just deep to the lens capsule, in the visual axis
Dot opacities

Answer 6

• dot opacities

Question 7

There are 4 main classifications of cataracts:

• nuclear
• index
• subscapular
• dot opacities

Which of these matches the following:

• due to steroid use
• just deep to the lens capsule, in the visual axis

Answer 7

• subscapular

Patients may describe glare when driving

Common in steroid users

Question 8

There are 4 main classifications of cataracts:

• nuclear
• index
• subscapular
• dot opacities

Which of these matches the following:

• change lens refractive index
• common in old age

Nuclear:
Polar: localized, commonly inherited, lie in the visual axis
Subcapsular:

Answer 8

• nuclear

Question 9

Of the following types of cataracts, which type is most common in diabetes?

1 - nuclear
2 - cortical
3 - subscapular
4 - dot opacities

Answer 9

2 - cortical

Question 10

There are 4 main classifications of cataracts:

• nuclear
• index
• subscapular
• dot opacities

Which of these matches the following:

• localized, commonly inherited
• lie in the visual axis

Answer 10

• index

Question 11

What is the term used to describe trauma related cataract?

1 - nuclear sclerotic
2 - cortical
3 - christmas tree
4 - rosette

Answer 11

4 - rosette

Question 12

Patients with suspected cataracts can present with all of the following clinically, except which one?

1 - acute vision loss
2 - faded colour vision: making it more difficult to distinguish different colours
3 - Glare: lights appear brighter than usual
4 - Halos around lights

Answer 12

1 - acute vision loss

Typically vision loss is slow

Question 13

In cataracts, is there a defect in the red reflex?

Answer 13

• yes

Cataracts prevent light from getting to the retina, hence you see a defect in the red reflex

Question 14

Typically in cataracts what 2 tests are performed to diagnose a patient?

1 - slit-lamp examination
2 - full blood work-up
3 - lens biopsy
4 - ophthalmoscopy

Answer 14

1 - slit-lamp examination
4 - ophthalmoscopy

Fundus and optic nerve are typically normal

Question 15

Which of the following non-surgical approaches are used in patients with early cataracts?

1 - stronger glasses/contact lens
2 - use of brighter lighting
3 - optimise health
4 - all of the above

Answer 15

4 - all of the above

These do not step cataracts though and eventually surgery is required

Question 16

Surgery is typically required in cataracts, which involves removing the cloudy lens and inserting an artificial lens. According to NICE, what are the requirements that a patients must have in order to get surgery?

1 - living with cataracts for >5 years
2 - other comorbidities
3 - significant effect on the quality of life of the patient
4 - aged >65

Answer 16

3 - significant effect on the quality of life of the patient

Question 17

What is the success rate of cataracts surgery?

1 - 85-90%
2 - 60-75%
3 - 45-60%
4 - 30-50%

Answer 17

1 - 85-90%

6 out of 12 people have vision improvements as well

Question 18

All cataracts surgery has a good success rate, which of the following are complications associated with it?

1 - Posterior capsule opacification: thickening of the lens capsule
2 - Retinal detachment
3 - Posterior capsule rupture
4 - Endophthalmitis: inflammation of aqueous and/or vitreous humour
5 - all of the above

Answer 18

5 - all of the above

Endophthalmitis can occur following infection and lead to blindness