Clinic: Cataract workup Flashcards
What symptoms might a cataract patient complain about? (6)
Glare Visual clarity Reduced Vision Haloes Flare Polyopia
What is the main thing you should determine in history for a new cataract patient?
Onset - is it sudden or gradual. Should be gradual. If it’s sudden, then think about differentials.
What should you assess for when checking VA of a cataract patient?
Do they still meet driving standards (6/12 OU)
What history questions should you ask in a post-operative cataract patient?
Date of sx + which eye(s) operated on
Surgeon/Hospital
General px satisfaction with operation - comfort + recovery of vision
Post op medications, if still using, under review still? + what drops (antibiotics, anti-inflammatories)
Any surgical complications
Any symptoms
List the key parts of a clinical workup for a cataract patient (4)
Presenting vision w/wout glasses
Refraction (any myopic shift?) (trial frame yeah)
Pinhole VA
Slit lamp assessment of the lens
Why do pinhole VA on cataract patients?
to determine how much of problem is cataract vs refractive change
How do we grade and assess SL assessment of a cataract lens?
Grade: clear 0 to brown 4
Location: central or peripheral
Type of cataract
I would use the WHO grading system so NUC1 to NUC3 would be good
How does WHO grade cortical cataracts
COR-1: less than 1/8th circumference
COR-2: less than 1/4 circumference
COR-3: half or more of circumference
COR-9: cannot grade
How does WHO grade PSCs?
0: less than 1mm
PSC-1: less than 2mm
PSC-2: less than 3mm (progression which may require surgery)
PSC-3: 3mm or more (usually requires surgery)
List 3 additional tests you can use to assess cataract patients
Retinometry or Potential Acuity Meter (if doubt about vision potential)
Contrast sensitivity on MET
Bright Acuity Tester (BAT) to assess glare disability
What vision is generally required for public cataract surgery?
6/12 or worse
How long is the typical wait for public cataract surgery?
around 6 months or more
