Cataract

Intro

Cataract represents opacification of the crystalline lens.

Presentation

  • Blurred vision
  • Glare
  • Washed-out colour vision (especially blue)

History

  • Decrease in vision
  • Myopic shift: frequent increases in prescription strength
  • Difficulties driving/ reading
  • Risk Factors (age >65, smoking, UV exposure, diabetes mellitus, trauma, long-term steroid use, family history)

Examination

  • Reduced visual acuity (VA)

Special investigations

Slit-lamp examination

  • Opacification of the lens
  • Fundoscopy: normal, possible defect in red reflex

Tonometry

  • Normal intraocular pressure (IOP)

Glare vision test

  • Reduced VA

Management

  • Phacoemulsification + intra-ocular lens implant
  • Correction of residual refractive error (likely to need reading glasses)

Complications

Of cataract

Of surgical intervention

  • Posterior capsular tear
  • Cystoid macular oedema
  • Endophthalmitis
  • Posterior subcapsular opacification
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