Cataracts

Question 1

What is it?

What is it?

Answer 1

Opacification of lens

Age-related pigment build-up

Question 2

What does the opacity lead to?

Answer 2

Reduced transparency and reduced refractive index

Hence visual impairment

Question 3

Causes:

• Med
• Congenital - genetic (1) - infection (2)
• Ocular disease
• Endocrine disease
• Type of radiation - 2

Answer 3

Steroids

Trisomy
Infection - rubella and HSV

Glaucoma
Severe myopia
Retinal detachment

DM

UV or infrared radiation

Question 4

Symptoms:

Obvious symptom

What may bright lights do to the eyes?

What may happen in one eye?

Answer 4

Blurred vision with a gradual decrease in acuity, with difficulty in reading, watching TV and recognising faces.

There will be a glare - almost like cats

Diplopia

Stereopsis

Question 5

Signs:

What may reduced in the eyes on fundoscopy?

What can you see on the lens?

Answer 5

Reduced red reflex

Clouded lens

Question 6

How is it diagnosed?

Answer 6

Clinical diagnosis

Can be supported by slit lamp with a dilated pupil

Question 7

Management - Non-surgical:

Why is conservative Rx often used initially?

Who should be contacted?

Answer 7

Highly varied rate of progression, with significant impairment, often taking years to develop

DVLA

Question 8

Management - Surgical:

When are surgical interventions needed?

What is phacoemulsification and how is it done?

How long does it take?

Answer 8

Lens broken up with USS and aspirated from the eye

It is an extracapsular extraction i.e. lens removed but lens capsule left in place

Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.

20 minutes under LA

Question 9

Surgical complications:

• Perioperative - 3
• Early post-op - 2
• Late post-op - 2

Answer 9

Haemorrhages
Local anaesthetic-related
Vitreous loss

Endophthalmitis
Eye or eyelid bruising

Posterior capsular opacification causing bruising vision
Retinal detachment