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    Cataracts by Idris Harunani

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    Cataracts are the partial or complete loss of transparency of the crystalline lens or its capsule. They are the leading cause of blindness worldwide. Cataracts often develop with age but can be caused by trauma, diseases like diabetes, steroid use, or UV/infrared exposure. Symptoms include blurred or misty vision and increased difficulty with tasks like reading. Cataracts are diagnosed through eye exams where doctors check visual acuity and look for changes in the lens appearance. While previously untreatable, cataracts can now be surgically removed, usually as an outpatient procedure, and corrected with intraocular lenses or glasses.

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    Cataracts by Idris Harunani

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    x2tnnwjhtv
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    Cataracts are the partial or complete loss of transparency of the crystalline lens or its capsule. They are the leading cause of blindness worldwide. Cataracts often develop with age but can be caused by trauma, diseases like diabetes, steroid use, or UV/infrared exposure. Symptoms include blurred or misty vision and increased difficulty with tasks like reading. Cataracts are diagnosed through eye exams where doctors check visual acuity and look for changes in the lens appearance. While previously untreatable, cataracts can now be surgically removed, usually as an outpatient procedure, and corrected with intraocular lenses or glasses.

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    An article about Cataracts written by Idris B, Harunani

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    Cataracts By Idris Harunani

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    Cataracts are the partial or complete loss of transparency of the crystalline lens or its capsule. They are the leading cause of blindness worldwide. Cataracts often develop with age but can be caused by trauma, diseases like diabetes, steroid use, or UV/infrared exposure. Symptoms include blurred or misty vision and increased difficulty with tasks like reading. Cataracts are diagnosed through eye exams where doctors check visual acuity and look for changes in the lens appearance. While previously untreatable, cataracts can now be surgically removed, usually as an outpatient procedure, and corrected with intraocular lenses or glasses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    7 views2 pages

    Cataracts by Idris Harunani

    Uploaded by

    x2tnnwjhtv
    Cataracts are the partial or complete loss of transparency of the crystalline lens or its capsule. They are the leading cause of blindness worldwide. Cataracts often develop with age but can be caused by trauma, diseases like diabetes, steroid use, or UV/infrared exposure. Symptoms include blurred or misty vision and increased difficulty with tasks like reading. Cataracts are diagnosed through eye exams where doctors check visual acuity and look for changes in the lens appearance. While previously untreatable, cataracts can now be surgically removed, usually as an outpatient procedure, and corrected with intraocular lenses or glasses.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Cataracts: Signs, Symptoms and Management

    By Idris Harunani F.B.D.O (Hons); CL, SLD.


    Practicing Proprietor at Focal Point Opticians – Mombasa; Kenya

    A cataract is the partial or complete loss of


    transparency of the crystalline lens substance or its
    capsule. Cataracts are the most important causes of
    blindness in the world today. The prevalence of
    cataracts increases with age; 65 percent of people
    aged 50 – 59 have opacities and all those aged over
    80. Cataracts can easily be seen during routine eye
    examinations.

    CAUSES
    They may occur as a result of age, trauma, systemic
    diseases (e.g. diabetes), ocular diseases (e.g. anterior A change in the appearance of the lens
    uveitis), high myopia, long term steroid therapy,
    excessive exposure to infrared and ultraviolet light, SYMPTOMS
    maternal infections, Down’s syndrome, etc. Symptoms depend on whether the cataracts are
    unilateral or bilateral and the degree and position of the
    opacity. If the cataract is unilateral, the patient may not
    notice its effects until he has cause to cover the good
    eye. The main symptom is a gradual loss of vision,
    often described as ‘misty’. Patients may complain of
    difficulty in reading (which should be differentiated from
    presbyopia that is normal in older people), recognizing
    faces and in watching television.

    A change in the appearance of the lens(Cross Section)


    SIGNS
    a) A reduction in visual acuity
    The degree of visual impairment depends on
    the nature of the cataract and the conditions of
    testing. Visual acuity should also be tested
    with a pinhole to eliminate refractive errors.
    b) A diminished red reflex on
    Ophthalmoscopy
    Upon viewing the eye with an ophthalmoscope
    from about two feet, the fundus can be seen
    as a “red reflex.” This is the troublesome reflex
    often seen in photographs of people taken
    with a flashlight. If there is any opacity
    between the cornea and the retina, this reflex
    will have opacities in it. The nature of the
    opacities in the reflex will depend on the
    position and extent of the opacities in the
    optical media. This reflex is more easily seen Illustration of ‘Normal Vision’ & ‘Higher Order
    in the dilated pupil. Abberations’
    c) A change in the appearance of the
    lens
    If one shines bright light on the eye, the lens Some patients may notice transient monocular diplopia
    may appear brown, or even white if the (double vision), other fixed spots (not floaters) in the
    cataract is more advanced as shown in the visual field and other better vision in subdued
    photograph. illumination. Some patients may even report that they
    can read without spectacles. This happens when a
    nuclear sclerotic cataract increases the converging
    power of the crystalline lens, so making the patient
    myopic (short-sighted).

    1
    MANAGEMENT is restricted and there is a “blind” area all round within
    There is no effective medical treatment for established this field because of the optical aberrations inherent in
    cataracts. The treatment is surgical. such powerful lenses. The effects of these problems
    can be minimized by the use of contact lenses or an
    INDICATIONS FOR OPERATION intraocular lens implant. (Also known as an IOL.)
    The decision to operate depends primarily on the effect
    of the cataracts on the patient’s vision. With advances
    in operative techniques, the operation may be done at
    any stage with minimal risk. There is no set level below
    which an operation is essential but most patients with
    vision 6/18 or worse in both eyes as a result of lens
    opacities usually benefit from cataract extraction. Some
    elderly patients, however, may be perfectly happy with
    this level of vision. Simple advice may be adequate,
    such as recommending that they use a good reading
    lamp that provides illumination from above and behind.
    A younger patient with more exacting visual demands Thick, heavy spectacles
    may opt for operation much earlier. (The minimum (Post surgery use-No implant)
    standard for driving is about 6/10, which is equivalent to
    a line between 6/9 and 6/12.)
    CONTACT LENSES
    On the whole, the surgeon’s advice is tailored to the
    The size of an image with a contact lens is only 10
    individual patient. The whole concept of a “ripe”
    percent larger than the image in the normal eye. The
    cataract is now obsolete. Most patients can be
    brain can fuse this discrepancy so that both an
    operated under local anaesthesia as day cases.
    operated eye and an unoperated eye may be used
    simultaneously. The patient thus enjoys the benefits of
    POST OPERATIVE CARE binocular single vision. Most patients, however, are
    Most patients are treated for several weeks with steroid elderly and problems may arise because of an
    drops to reduce inflammation and antibiotic drops to inadequate tear film, difficulties with lens handling and
    prevent infection. Patients are traditionally advised to infection.
    avoid activities that may raise their intraocular
    pressures, such as strenuous exercise or heavy lifting,
    for a few weeks after the operation.

    OPTICAL CORRECTION AFTER OPERATION


    Removal of the crystalline lens results in an eye with a
    large hypermetropic (long-sighted) refractive error for
    which the eye cannot compensate without artificial
    correction. This refractive error is now usually corrected
    with a plastics intraocular lens implant at the time of the An intraocular lens (IOL) is implanted in the eye in
    operation. If an implant has been inserted, spectacles place of the patient's clouded natural lens. Shown is
    will usually still be required for reading fine print as the Alcon's new AcrySof Natural IOL; the lens material is
    intraocular lens has a fixed focus. Alternatively, if an yellow because it filters out blue light, which may be
    implant is not used, spectacles or contact lenses are to
    harmful to eyes.
    be used to correct the refractive error.

    SPECTACLES  Published in the “Medical Review


    The natural lens has great refractive power and Journal- Nov/ Dec 1998”
    consequently the spectacles required to correct the
    post-operative refractive error are thick and heavy even  Revised: November 2004
    they are made of plastics. The corrected retinal image
    is about 30 percent larger than that seen by the normal
    (emmetropic) eye. This means that the image from an
    eye that has had a cataract extraction with subsequent
    spectacle correction cannot be fused with the other eye
    unless the cataract in the other eye is also removed.
    Objects are also perceived to be closer than they are,
    often resulting in accidents – for example, pouring tea
    into one’s lap rather than into a cup. The field of vision

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