Cataracts

Descripción

(Opthalmology) Specials Fichas sobre Cataracts, creado por Liam Musselbrook el 16/12/2016.
Liam Musselbrook
Fichas por Liam Musselbrook, actualizado hace más de 1 año
Liam Musselbrook
Creado por Liam Musselbrook hace alrededor de 8 años
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The lens: what's it comprised of? Inner nucleus of old inactive cells, cortex and outer anterior epithelium (active cells) Whole lens is encapsulated
What is a cataract and what causes it? Opacity on or within the lens Either the accumulation of water or the denaturation of proteins within the lens
How might a cataract typically present? Reduced acuity/contrast Decreased colour sensitivity Monocular diplopia Glare, ghosting Decrease in refractiom
Congenital aetiology of presenile cataracts Congenital cataracts often polar, zonular Rubella - 50% if infected in 1st/2nd trimester Toxoplasmosis, CMV, Thalidomide, steroids Familial Down’s syndrome Lowe’s syndrome Myotonic dystrophy
Metabolic aetiology of presenile cataracts Diabetes mellitis (accelerate age-related cataracts or cause snowflake caracts) Galactosaemia Hypocalcaemia Wilson's disease
Pharmacological aetiology of presenile cataracts Steroids Miotics Amiodarone
Trauma aetiology of presenile cataracts Penetrating injury Blunt injury Glass Blower’s cataract (infrared radiation) Electric shock Ionising radiation
Nuclear cataract Typically older patients Central portion becomes opaque Affects distance vision more than near Poor night vision, lights seem excessively intense Change refractive index of lens - Myopic shift
Post subcapsular cataract Granular appearance May affect younger patients Affects near vision more Poor vision in bright light - glare, halos Associations: diabetes, steroids, uveitis
Cortical cataracts Opacification of lens cortex Radial spoke-like configuration May not affect vision unless on the visual axis May cause monocular diplopia Associations: age, diabetes, UV, radiotherapy
Classification of cataract by development Immature: not visually- impairing, red reflex present Mature: lens completely opaque Hypermature (Morgonian): lens becomes small and wrinkled due to leakage of water - risk of glaucoma
Differentials for cataracts Macular degeneration Prysbyopia Retinal disease
What is the treatment for Phacoemulsification + intra-ocular lens (IOL) implant
What are the complications of cataract surgery? Rupture of capsule and vitreous loss (4%) Trauma to iris Choroidal haemorrhage Vitreous haemorrhage Endopthalmitis Late: Posterior capsule opacification, Retinal detachment (1%), Glaucoma, Lens dislocation, Macular oedema
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