Gradual vision loss

Question 1

What are some causes of gradual vision loss?

Answer 1

• Cataracts
• Refractive error
• Dry ARMD
• Open-angle glaucoma
• Diabetic retinopathy

Think ABC:

A - Age-related macular degeneration (Dry)

B - Blur (Refractive error)

C - Cataracts

Question 2

What are cataracts?

Answer 2

Opacifications within the lens

Question 3

What are some different types of cataract?

Answer 3

• Nuclear cataract
• Posterior sub-capsular cataract
• Christmas tree cataract (Polychromatic cataract)
• Mature cataract

Question 4

What is shown?

Answer 4

Posterior sub-capsular cataract

Question 5

What is shown?

Answer 5

Flower shaped cataract (Blunt trauma)

Question 6

What are some risk factors for developing cataracts?

Answer 6

• Ageing
• UVB damage
• Hypertension
• Smoking
• Post-op and trauma
• Steroids
• Metabolic disorders (E.g. Diabetes)
• Genetics

Question 7

How do cataracts form with age?

Answer 7

1. Epithelium of the lens matures
2. Eventually cell contents are replaced and nucleus disappears
3. Cell outline is left and becomes a fibre within the cels
4. Degenerative changes in lens fibre proteins (Crystallins) results in chemical and structural alteration
5. Causing loss of transparency

Question 8

How do cataracts present?

Answer 8

Gradual visual loss (‘hazy’/’blurred’)

Question 9

How can cataracts be managed?

Answer 9

• Surgical removal (Phaecoemulsification) with intra-ocular lens implant if patient is symptomatic
• Phaecoemulsification pulses the lens and degrades it