Risk Factors

Question 1

What is the biggest risk factor for cataracts?

Answer 1

Age

Question 2

What do modifiable risk factors do?

Answer 2

They reduce the degree of oxidative stress

Question 3

Describe why smoking is a risk factor for cataracts?

Answer 3

Because it accelerates all lens opacities due to highly oxidative stress.

Question 4

Which cataracts arise from smoking?

Answer 4

Psc an nuclear is accelerated by smoking but the strongest association is nuclear cataract

Question 5

Why is uv radiation a risk factor for cataracts?

Answer 5

Long periods of exposure to sunlight accelerate ageing allowing for the development of opacities

Question 6

Which cataract is associated with uv radiation?

Answer 6

Cortical

Question 7

Why is diabetes a risk factor for cataracts?

Answer 7

The risk increases with the duration of diabetes and the presence of diabetic macular oedema and Caracas develop younger

Question 8

Which type of diabetes is cataract more prevalent for?

Answer 8

Type 1 and 2

Question 9

Why is trauma a risk factor for cataracts? And what types of trauma can they be?

Answer 9

They can be penetrating or blunt. A penetrating injury causes a break in the lens capsule causing an uncontrollable amount of aqueous to transfer into the lens overhydrating the lens fibres leading to opacities. And it can be a localised or diffused opacity. A blunt trauma gives a larger and diffused opacity

Question 10

What medications are risk factors for cataracts?

Answer 10

• corticosteroids: a dose of 1600 for over 5 years (lower risk for topical corticosteroids)
• choloropromazine: increases the risk of psc and is an anti psychotic drug

Question 11

What is the management for cataracts? (First line treatment)

Answer 11

Updating refractive correction if the first line

Question 12

In some conditions why won’t updating specs work? And what can we do to improve the situations? And why is that an issue?

Answer 12

Because it will only correct blur driven by low order abberations but not high order abberations so residual blur may occur.
We can prescribe the change that gives us the highest va and will be the most useful to minimising blur but we need to consider whether the px can adapt to changes

Question 13

What can we do dispensing wise to help manage cataracts?

Answer 13

• We can use plastic specs to absorb wavelengths up to 350
• we can use high index plastics or good lenses to absorb 380 wavelengths
• specific uv absorbing filters can absorb into 400 wavelength (uva penetrates the eye more deep)

Question 14

Why are dispenses and frames important for cataracts?

Answer 14

Because they slow the development of cortical cataracts and reduce light scatter in nuclear cataracts

Question 15

Why are sunglasses used for cataract management?

Answer 15

They reduce light levels which reduce glare as less light enters the eye so less scatter

Question 16

In cataracts, what effect does miosis/dilation have?

Answer 16

For psc dilation allows light to avoid the opacity improving the opacity

For cortical cataracts it’s detrimental for a dilated pupil because it exposes opacities in the periphery to light which will increase light scatter

Question 17

What does absorptive tints do to pupil size?

Answer 17

It increases pupil size and dilates the pupil which decreases the depth of focus which then increases the effect of cataract induced abberations and defocus

Question 18

What non optical thing can the px do to reduce sx for cataract px’s?

Answer 18

Wear hat or caps that reduce glare

Question 19

How are anti reflective coatings used in management for cataracts?

Answer 19

They improve image contrast by decreasing additional scatter

Question 20

Can nutrition be used to manage cataracts?

Answer 20

No