Managing a px with cataract

Question 1

list 7 symptoms/affect on lifestyle of cataract

Answer 1

• cloudy/blurred vision
• colours seem faded
• glare: headlights/lamps/sunlight
• haloes around lights
• poor night vision
• double vision: less likely as the cataract gets larger
• frequent prescription changes

Question 2

list the 5 non-surgical management options for cataract

Answer 2

• new glasses
• brimmed hat
• sunglasses (antiglare)
• brighter lighting
• magnifying lenses

Question 3

list 9 benefits of surgery

Answer 3

• colours are brighter
• images are sharper
• less glare from sunlight and headlights
• more independence
• improved self confidence
• better safety, less falls
• for those that read, sew, do vdu work a lot, the ophthalmologist uses lens that works best for near vision and vice versa
• multifocal lenses available
• less dependence of glasses, may still need reading glasses

Question 4

list the 14 risks of cataract surgery and what causes each

Answer 4

• secondary cataract: cells grow under lens and blurs vision
• tearing of posterior capsule where vitreous body can leak into
• inflammation: swelling inside eye
• incision leak: increases chance on infection
• cystoid macular oedema: a few weeks - 3 months later, tissues of macula swell causing blurry central vision
• bleeding: at the incision end of cornea (but unlikely as no blood vessels there)
• intraocular infection: e.g. endopthalmitis (more common in those with comprised immune system)
• pronounced astigmatism: swelling of cornea from tight stitches which distorts the shape of the cornea
• retinal detachment: myopes more prone
• glaucoma secondary when inflammation or bleeding occurs
• bruising/black eye: from anesthetic injection
• decentered IOL: 1 week or month later, sometimes due to torn zonules
• hypopyon
• pupillary block

Question 5

what is the treatment for a secondary cataract

Answer 5

YAG laser used

Question 6

what is the treatment for tearing of the posterior capsule

Answer 6

repair the vitreous body that has leaked into the capsular bag and seal it off

Question 7

what is the treatment for a incision leak

Answer 7

the doc may apply a contact lens or bandage over the eye to avoid any chance of infection from a incision leak

Question 8

what is the treatment for cystoid macular oedema

Answer 8

non steroidal anti-inflammatory drug given

Question 9

what is done in order to avoid a intraocular infection from cataract surgery

Answer 9

antibiotic drugs given before, during and after surgery to minimize risk

Question 10

what is the treatment for secondary glaucoma

Answer 10

drops used or surgery

Question 11

what are the symptoms and treatment for a decentred IOL

Answer 11

• glare
• diplopia
• blur
• fluctuating vision when see through edge of IOL
• either reposition or replace lens

Question 12

list 5 reasons to refer a patient with a cataract

Answer 12

• can’t see fundus
• affects the px
• danger to selves/others
• long term cataract )can cause secondary glaucoma)