Cataract by GRP 5

Cataract
Objectives:
-Definition of Cataract
- Epidemiology
-Etiology
-Pathophysiology
-Sign & Symptoms
-Diagnosis
-Prevention
-Complication
-Treatment
Introduction
Cataract" is derived from the Latin cataracta,
meaning "waterfall“ Early in the development
of age-related cataract the power of the lens
may be increased, causing near-sightedness
(myopia), and the gradual yellowing and
opacification of the lens may reduce the
perception of blue colors
Defination
A cataract is a cloudy area in the lens of
the eye that leads to a decrease in
vision. Cataracts often develop slowly
and can affect one or both eyes.
Types of Cataract
1-Nuclear Sclerotic Cataract: A nuclear
sclerotic cataract refers to the
hardening of the nucleus, the center, of
the lens of the eye. In the early stages
of this condition, the lens becomes
cloudy and yellow before eventually
hardening (sclerosis is the medical term
for hardening).
Types of Cataract
1-Nuclear Sclerotic Cataract: A nuclear
sclerotic cataract refers to the
hardening of the nucleus, the center, of
the lens of the eye. In the early stages
of this condition, the lens becomes
cloudy and yellow before eventually
hardening (sclerosis is the medical term
for hardening).
 2-Cortical Cataract: A cortical cataract is a
condition in which areas of white cloudiness
will develop in the outer edges of the lens
called the cortex spreading inward and
having the appearance of a spoke wheel or a
star pattern.
 3-Posterior Subcapsular Cataract: Posterior
subcapsular cataracts begin as a small,

cloudy or opaque area on the back (posterior)
of the lens. It is called subcapsular because it
develops on the underside or beneath the
lens capsule.
Epidemiology
 Age-related cataracts are responsible for 51%
of world blindness, about 20 million people
Globally, cataracts cause moderate to severe
disability in 53.8 million (2004), 52.2 million
of whom are in low and middle income
countries.
Etiology
There are several underlying causes of cataracts.
These include:
 an overproduction of oxidants, which are oxygen
molecules that have been chemically altered due to

normal daily life
 smoking
 ultraviolet radiation
 the long-term use of steroids and other medications
 certain diseases, such as diabetes
 trauma
 radiation therapy
pathophysiology
It is not fully understood. There are three
metabolic pathways which convert glucose in
energy (ATP) and other relevant metabolic
molecules. These are:
1. Glycolysis
2. The Pentose Phosphate Shunt
3. The Polyol Route
• . 1. GLYCOLYSIS :Aging Decrease in
Hexokinase concentration Drop in ATP level
Poor control of electrolyte balance Massive
influx of water into the lens Disorganization
of structured proteins in the lens
Aggregation and precipitation of protein
CATARACT
• 2. HMP PATHWAY: Metabolization of 14%
glucose NADPH + H+ synthesis by glucose-
6-phosphate
• 3. POLYOL PATHWAY: High glucose level in
blood Polyol Pathway GlucoseSorbitol
Accumulation of sorbitol in lens Hyper
osmotic effect - Influx of excess water
through aquaporin channels CATARACT
Aldose Reductase Polyol dehydrogenase has
Sign & Symptoms
 Cataracts are a common part of the eye’s
aging process. Eventually, they can cause:
 Vision that’s cloudy, blurry, foggy or filmy.
 Sensitivity to bright sunlight, lamps or
headlights.
 Glare (seeing a halo around lights), especially
when you drive at night with oncoming

headlights.
Cont......
 Prescription changes in glasses, including
sudden nearsightedness.
 Double vision.
 Need for brighter light to read.
 Difficulty seeing at night (poor night vision).
 Changes in the way you see color.
Diagnosis
 Visual acuity test. This is a fancy way of
saying "eye chart exam." Your doctor will ask
you to read letters from a distance to find out
how sharp your vision is. First you'll try it with
one eye and then the other.
 Slit-lamp exam. This uses a special

microscope with a bright light that lets your
doctor check different parts of your eye.
Cont....
 Retinal exam. Your doctor puts drops in your
eyes to widen your pupils, the dark spots in
the middle that control how much light gets
in. This lets them get a good look at the
retina -- the tissue around the back of your
eyes -- and a better view of the cataract.
Prevention
 Have regular eye examinations. Eye
examinations can help detect cataracts and
other eye problems at their earliest
stages. ...
 Quit smoking. ...
 Manage other health problems. ...
 Choose a healthy diet that includes plenty
of fruits and vegetables. ...

 Wear sunglasses. ...
 Reduce alcohol use.
Complication of cataract
 Inflammation.
 Infection.
 Bleeding.
 Swelling.
 Drooping eyelid.
 Dislocation of artificial lens.
 Retinal detachment.
 Glaucoma.
Treatment of cataract
 The three most common types of medicated
eye drops for cataracts are antibiotics,
corticosteroids and anti-inflammatories.
Surgery is currently the only method of
cataract treatment that can successfully
restore vision for someone who suffers from
cataracts.
Medical Managment
 Aspirin: The drug decreases the substances
that cause pain and inflammation.
 Diclofenac Sodium Ophthalmic Solution :
Diclofenac Sodium Ophthalmic Solution is a

topical, nonsteroidal anti-inflammatory drug,
prescribed for the treatment of postoperative
inflammation in patients who have undergone
cataract extraction.
 Nepafenac Ophthalmic: Nepafenac
Ophthalmic is a non-steroidal anti-
inflammatory drug (NSAID), prescribed for
eye pain, redness, and swelling in patients
who are recovering from cataract surgery
Surgical Managment
 Lens replacement. There are three lens
replacement options:
 Phacoemulsification. A portion of the anterior
capsule is removed, allowing extraction of the

lens nucleus and cortex while the posterior
capsule and zonular support are left intact.
cont....
 Aphakic glasses. In aphakic glasses, objects are
magnified by 25%, making them appear closer than
they actually are.
 Contact lenses. Contact lenses provide patients with
almost normal vision, but because contact lenses
need to be removed occasionally, the patient also
needs a pair pf aphakic glasses.
 IOL implants. The most common IOL is the single
focus lens or monofocal IOL that cannot alter the
visual shape; multifocal IOLs reduce the need for
eyeglasses; accommodative IOLS mimic the
accommodative response of the eye.
Nursing Managment
 Recent medication intake. It is a common
practice to withhold any anticoagulant
therapy to reduce the risk of retrobulbar
hemorrhage.
 Preoperative tests. The standard battery of
preoperative tests such as complete blood

count, electrocardiogram, and urinalysis are
prescribed only if they are indicated by the
patient’s medical history.
cont....
 Vital signs. Stable vital signs are needed
before the patient is subjected to surgery.
 Visual acuity test results. Test results from
Snellen’s and other visual acuity tests are

assessed.
 Patient’s medical history. The nurse assesses
the patient’s medical history to determine the

preoperative tests to be required.
Nursing Goals
 The major goals for the patient include:

 Regaining of usual level of cognition.
 Recognizing awareness of sensory needs.
 Be free of injury.
 Identifying potential risk factors in the
environment.
 Appearing relaxed and reporting anxiety is
reduced at manageable level.

 Verbalizing feelings of anxiety.
 Identifying healthy ways to deal with and
express anxiety.
Nursing Interventions
 Care for a patient with cataract includes:
 Providing preoperative care. Use of
anticoagulants is withheld to reduce the

risk of retrobulbar hemorrhage.
 Providing postoperative care. Before
discharge, the patient receives verbal and

written instructions about how to protect
the eye, administer medications, recognize
signs of complications, and obtain
emergency care.
Evaluation
 Regained usual level of cognition.
 Recognized awareness of sensory needs.
 Free of injury.
 Identified potential risk factors in the
environment.
 Appeared relaxed and reporting anxiety is
reduced ti a manageable level.

 Verbalized feelings of anxiety.
 Identified healthy ways to deal with and
express anxiety.
References
 1.Bobrow JC Breadsley TL Jick SL et al.

 Lens and cataract.
 American Academy of Ophthalmology, San
Francisco2015–16
https://nurseslabs.com › cataract
Web results
Cataract Nursing Care Management:
Study Guide for Nurses - Nurseslabs

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Cataract

subcapsular cataracts begin as a small,

molecules that have been chemically altered due to

 the long-term use of steroids and other medications

 certain diseases, such as diabetes

when you drive at night with oncoming

 Slit-lamp exam. This uses a special

of fruits and vegetables. ...

Diclofenac Sodium Ophthalmic Solution is a

capsule is removed, allowing extraction of the

preoperative tests such as complete blood

Snellen’s and other visual acuity tests are

the patient’s medical history to determine the

 The major goals for the patient include:

reduced at manageable level.

anticoagulants is withheld to reduce the

discharge, the patient receives verbal and

reduced ti a manageable level.

 1.Bobrow JC Breadsley TL Jick SL et al.

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