1 Cataract

CATERACT
DR. SNEHAL PATIL

Eye lens
DEFINIITON
• It is clouding or opacity that
develops in crystalline lese of
eye or in its envelop, varying
in degree from slight to
complete opacity and
obstructing passage of light
Clinical stages of development
• Immature
• There are some remaining clear
areas in the lens
• Mature
• Completely opaque
• Hyper mature
• leaky liquid surface that
may cause inflammation
of other eye structures.
Classification : etiological
• Congenital :
• linked to genes
• Acquired
• Acquired during life period
• Senile
• It is an age-related, vision-impairing disease
• characterized by gradual progressive clouding and
thickening of the lens of the eye
• Traumatic
• Many kind of injuries to eye can lead to a cataract.
• Metabolic
• Metabolic disorder like insulin dependent DM,
• Radiational
• Due to exposure to radiation therapy for
cancer , UV rays , Xrays
• Secondary Cataracts
• Another condition or a medical treatment leads
to a cataract
• DM, taking steroids , surgeries to eye
Classification : morphological
• Nuclear cataracts
• Cataracts affecting the center of
the lens
• Lens gradually turns densely
yellow and further clouds vision.
• Lens may even turn brown as
disease progress
• Cortical cataracts
• Cataracts that affect the edges of the lens
• Whitish, wedge-shaped opacities or
streaks on the outer edge of the lens
cortex.
• Streaks extend to the center and interfere
with light passing through the center of
the lens.
• Posterior subcapsular
cataract
• Small opaque or cloudy
area on the "posterior,"
or back surface of the lens
risk factors
• Increasing age
• Diabetes
• Excessive exposure to sunlight
• Smoking
• Obesity
risk factors
• High blood pressure
• Previous eye injury or inflammation
• Previous eye surgery
• Prolonged use of corticosteroid medications
• Drinking excessive amounts of alcohol
Pathophysiology
• Degenrative process
• Opacification of lens fiber
• Reduce ability of lens to refract lights
• Reduce visual acuity
• Chemical modification in lens
• Lens become thicken and harden

Clinical features
• White pupil
• Increasing difficulty with vision
at night
Clinical features
• Sensitivity to light and glare
• Seeing "halos" around lights
Clinical features
• Clouded, blurred or dim vision
Clinical features
• Double vision in a single eye
• Decrease color perception
• Decrease visual acuity
• Photophobia
Diagnostic evaluation
• Visual acuity test.
• Uses an eye chart to measure
how well patient can read a
series of letters.
• Eyes are tested one at a time,
while the other eye is covered.
• Slit-lamp examination.
• It is routine procedure where a
shines a light into the eye to look
for injuries or diseases.
• Retinal exam.
• Sometimes called ophthalmoscopy or
fundoscopy
• Using a slit lamp or
ophthalmoscope to evaluate
retina, optic disk and choroid
Management
• Extracapsular cataract extraction
• Removing the eye’s natural lenses
while leaving the back of the
capsule that holds the lens in
place.
Management
• Intracapsular cataract extraction
(ICCE)
• It involves the removal of
the lens and the surrounding lens
capsule in one piece
Management
• Phacoemulsification
• It is modern cataract surgery
• Eye's internal lens is emulsified with an
ultrasonic handpiece and aspirated
from the eye.
• Aspirated fluids are replaced with
irrigation of balanced salt solution to
maintain the anterior chamber.
Management
• Intraocular lens implantation
(IOL)
• It is a synthetic, artificial lens
placed inside the eye that
replaces the focusing power
of a natural lens which is
surgically removed
Management
• Cryosurgery
• Cryoprobe (hollow metal tipped
prob) cooled by liquid nitrogen,
that is touched to lens surface
• As temperature of probe tip falls
below freezing lens adheres to it
Management
• Contact lens
• A contact lens is a lightweight
corrective, cosmetic or
therapeutic device that is usually
placed directly onto the cornea of
the eye.
Assignment
• What is pre and post operative care for

cataract surgery?

1 Cataract

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CATERACT

DR. SNEHAL PATIL

• Opacification of lens fiber

• Reduce ability of lens to refract lights

• Reduce visual acuity

• Chemical modification in lens

• Lens become thicken and harden

• What is pre and post operative care for

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