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    Ophtha Case Report

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    Joy Mae Ann Peralta
    This document describes the case of a 57-year-old male who presented with gradual blurring of vision in the right eye over 3 years. On examination, the patient was found to have leukocoria, reduced visual acuity in the right eye, and a mature cataract in the right eye. The differential diagnosis included cataract, error of refraction, open angle glaucoma, and diabetic retinopathy, but cataract was determined to be the most likely diagnosis given the patient's age, symptoms, and examination findings. The document then provides details on cataract types, pathogenesis, clinical features, and surgical management options.

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    Ophtha Case Report

    Uploaded by

    Joy Mae Ann Peralta
    269 views17 pages
    This document describes the case of a 57-year-old male who presented with gradual blurring of vision in the right eye over 3 years. On examination, the patient was found to have leukocoria, reduced visual acuity in the right eye, and a mature cataract in the right eye. The differential diagnosis included cataract, error of refraction, open angle glaucoma, and diabetic retinopathy, but cataract was determined to be the most likely diagnosis given the patient's age, symptoms, and examination findings. The document then provides details on cataract types, pathogenesis, clinical features, and surgical management options.

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    This document describes the case of a 57-year-old male who presented with gradual blurring of vision in the right eye over 3 years. On examination, the patient was found to have leukocoria, reduced visual acuity in the right eye, and a mature cataract in the right eye. The differential diagnosis included cataract, error of refraction, open angle glaucoma, and diabetic retinopathy, but cataract was determined to be the most likely diagnosis given the patient's age, symptoms, and examination findings. The document then provides details on cataract types, pathogenesis, clinical features, and surgical management options.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    269 views17 pages

    Ophtha Case Report

    Uploaded by

    Joy Mae Ann Peralta
    This document describes the case of a 57-year-old male who presented with gradual blurring of vision in the right eye over 3 years. On examination, the patient was found to have leukocoria, reduced visual acuity in the right eye, and a mature cataract in the right eye. The differential diagnosis included cataract, error of refraction, open angle glaucoma, and diabetic retinopathy, but cataract was determined to be the most likely diagnosis given the patient's age, symptoms, and examination findings. The document then provides details on cataract types, pathogenesis, clinical features, and surgical management options.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 17
    At a glance
    Powered by AI
    The document discusses different types of cataracts, their pathogenesis and management options like ECCE and phacoemulsification.

    The different types of cataracts mentioned are nuclear, cortical, subcapsular and senile cataracts.

    The steps involved in phacoemulsification are capsulorrhexis, hydrodissection, sculpting of the nucleus, cracking of the nucleus, emulsification and removal of cortex and insertion of IOL.

    C.

    R
    57/M
    Married
    Patient Profile

    3 yrs PTC, px noted gradual blurring of vision of
    the right eye
    (-) eye pain
    (-) redness
    (-) tearing
    (-) dicharge

    CONSULT

    History of Present Illness

    Past Medical History
    HTN (Amlodipine, 2 yrs)

    Past Ocular History
    Unremarkable

    Family History
    Unremarkable
    History of Present Illness

    Anicteric Sclerae, Pink Palpebral Conjunctivae,
    Leukocoria, 2-3 mm EBRTL, (-) redness, (-) discharge
    Visual Acuity
    OD: HM w/ GLP
    OS: 6/6
    EOMs
    full
    IOPs
    OD: soft
    OS: soft
    Fundoscopy
    OD: (-) ROR
    OS: (+) ROR, CM, DDB, CDR 0.4, AVR 2:3
    Eye Examination

    SUDDEN GRADUAL TRANSIENT
    PAINLESS PAINFUL
    Ischemic Optic
    Neuropathy
    Retinal
    Artery/Vein
    Occlusion
    Acute Angle
    Closure
    Glaucoma
    Corneal Ulcer
    Uveitis with
    Complications
    Cataract
    Error of
    Refraction
    Open Angle
    Glaucoma
    DM
    Retinopathy
    Age-related
    Macular
    Degeneration
    Subacute
    Angle
    Closure
    Glaucoma
    Uveitis
    Optic
    Neuritis
    Uveitis
    Papilledema
    Amaurosis
    Fugax

    Differential Diagnosis

    Cataract
    57 y/o
    Leukocoria
    Error of Refraction
    Not improved with pinhole
    Open Angle Glaucoma
    Normal IOP
    DM Retinopathy
    No DM
    Age-related Macular Degeneration
    Central vision is not affected
    Gradual, Painless

    Cataract Senile Mature, OD
    Assesment

    Definition:
    Opacity in the lens
    Most common cause:
    Aging
    Other causes:
    trauma
    systemic dse (DM)
    smoking
    heredity
    Cataract

    Pathogenesis
    not completely understood.
    cataractous lenses protein aggregates that
    scatter light rays and reduce transparency.
    Factors:
    oxidative damage (from free radical reactions)
    ultraviolet light damage
    malnutrition
    NO medical treatment to retard or reverse
    cataract formation.
    protective effect from dietary carotenoids (lutein)
    Cataract

    Mature
    All of the lens protein is opaque
    Leukocoria
    Immature
    Some transparent protein
    Black opacity against a red orange background
    Intumescent
    Lens take up water
    Hypermature
    Cortical proteins have become liquid escape shrunken lens
    with wrinkled capsule
    Morgagnian
    Hypermature cataract in which lens nucleus floats freely in the
    capsular bag
    Cataract

    Most common type
    Age-related
    Types
    Nuclear
    Cortical
    Subcapsular
    Senile Cataract

    Nuclear (Hard) Cataract
    Hardening of the nucleus d/t compacting &
    sclerosing of the lens fiber in the center of the lens
    yellow-brown pigments
    Myopic shift in refraction
    Early onset of BOV (Far vision)

    Senile Cataract

    Cortical (Soft) Cataract
    Hydration of the cortex with development of
    subcapsular vacuoles which disrupts regular
    arrangement of lens fiber
    Opacity begins at periphery (radial spoke-like
    opacities)
    Late onset of BOV
    Senile Cataract

    Posterior Subcapsular Cataract
    cortex near the central posterior capsule.
    Posterior migration of lens epithelium
    Near vision is affected early
    Associated with DM, trauma, corticosteroid use
    (topical or systemic), inflammation, or exposure to
    ionizing radiation.
    Senile Cataract

    Extracapular Cataract
    Extraction (ECCE)
    Anterior capsule, nucleus &
    cortex are removed
    Posterior capsule is left
    behind to support the
    intraocular lens
    Complications:
    No accomodation, with
    astigmatism
    Procedure:
    Anterior Capsulotomy
    Completion of Incision
    Removal of Nucleus
    Removal of Cortex
    Insert IOL
    Suturing







    Management of Cataract

    Phacoemulsification
    Latest method
    Use of ultrasonic vibrator to
    disintegrate nucleus
    Sutureless
    Procedure:
    Capsulorrhexis
    Hydrodissection
    Sculpting of the Nucleus
    Cracking of the Nucleus
    Emulsification
    Removal of Cortex
    Insertion of IOL


    Management of Cataract

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