Lens

Question 1

Katarakt Hikayede ne sorarsın?

Answer 1

➢ Az görme, bozuk görme, göz kamaşması, renk ayırt edememe var mı? Ne zamandan beri? Nasıl ilerledi?
➢ Göz hastalıkları, sistemik hastalıklar (AD)
➢ Daha önce geçirilen ameliyatlar
➢ Kullanılan ilaçlar
➢ Ailede göz hastalıkları, başka sistemik hastalıklar

Question 2

Etiology Katarakt

Answer 2

➢ Senil (most common)
➢ Sistemik Hastalıklar (diyabet, galaktozemi, diyaliz, myotonik distrofi, skin diseases)
➢ Sekonder ya da komplike (iridocyclitis, vaskülit, retinitis pigmentosa)
➢ Travmatik
➢ Toxic (mostly steroids)

Question 3

Katarakt tedavide neler yaparsın?

Answer 3

➢ Katarakt tedavisi cerrahidir.
Anestezi topikal (used mostly), subtenon, retrobulbar ya da genel olarak verilebilir (not really used)
old methods (not really used):
√ Intracapsular cataract extraction
√ Extracapsular cataract extraction
new methods:
√ Phacoemulsification (gold standard)
+ (could be done in addition to pahco.):
√ Femtosecond laser cataract surgery

➢ Intraoküler lens takılır: monofocal, trifocal, toric (in astigmatic)

➢ Eğer lens epitel hücre proliferasyonu olursa sekonder katarakt gelişebilir. Bu
durumda yag laser capsulotomy yapılır.

Question 4

How is congenital cataract treated?

Answer 4

➢ needs emergent surgery
➢ Katarakt ameliyatının 4-6 haftadan itibaren yapıldığını, artifisyel lens konulmadığını, diğer gözde katarakta olmadığı için çocuk 2 yaşına gelip ikinci ameliyat ile artifisyel lens konulana kadar kontakt lens verilmesi gerektiğini söyledim.
(in short: < 2y.o -> use lense if only one eye effected if both use glasses, after 2y.o do another sx for artifical contact lense)
➢ Kontakt lens takmazsa ne olur diye sordu.
-> amblyopi (göz tembelliği) , strabismus ve nistagmus
->Lazy eye (amblyopia) is reduced vision in one eye caused by abnormal visual development early in life

Question 5

Lökokori sebepleri

Answer 5

➢ Konjenital katarakt
➢ Retinablastoma
➢ Retinal dekolman
➢ ROP
➢ Retinal displazi
➢ Kolobom
➢ Toxoplasmosis
➢ Toxocariasis

Lökokori sebepleri
➢ En sık konjenital katarakt
➢ En önemlisi retinablastoma
➢ ROP (grade 5)
➢ Tumors:
➢ Congenital Malformations:
➢ Vascular Diseases:
➢ Inflammatory Diseases:
➢ Trauma

Question 6

Pediatrik grupta katarakt sebepleri

Answer 6

➢ Travma
➢ Galaktozemi
➢ Enfeksiyon
(d/t systemic diseases: diabetes, galactosemia, dialysis catarcts, skin diseases (AD), myotonic dystrophy)

Question 7

Konjenital katarakt sebepleri

Answer 7

➢ Herediter
➢ 1. Trimesterda transplacental enfeksiyon
√ Rubella (en sık)
√ Mumps
√ Hepatit
√ Toxoplasmosis

Question 8

CF of cataract patients

Answer 8

dec. vision
distorted vision
glare
disturbance of color vision

Question 9

Older patient gets rid of reading glasses what kind of cataract do you think?

Answer 9

senil cataract
it is: nuclear (slowly progresisve, letnicular myopia, second youth of sight)

other types:
cortical (rapid progression)
post. subcapsular (rapid progression, loss of near vision)

Question 10

Which cataracts require emergent surgery?

Answer 10

hypermure (morgagnian) cataracts (lens proteins into aqueous humore -> phacoloytic glaucoma
cong. cataract

Question 11

Compare the diff. types of intraocular lenses

Answer 11

monofocal (well w/o lense at distance but needs reading glasses)
trifocal (good at near & interm. & far w/o glasses)
toric (used in astigmatic patients)

Question 12

What are possible causes of lens dislocation?

Answer 12

trauma (most common)
pseudoexfolitation syndrome
ciliary body tm
marfan syndrome (lens is up-outwards)
homocystinuria, lens: down-inwards
weill- marchesani syndr.