Opthamology essay 50 - Grade: 5 PDF

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50. SENILE CATARACTS, FORM, STAGES, TREATMENT. APHAKIA • •

Cataract present when transparency of lens is reduced to point that patients vision is impaired Senile – most frequent form of acquired cataract

o Cause – exact unknown. Often familial hence do good history o Rf- increasing age, diabetes, atopic dermatitis, myotonic dystrophy, trauma • Classification: o Nuclear  30% o Subcapsular  50% o Posterior subcapsular • •

 20%  In nuclear, sub and posterior sub- distorted +blurred vision, diminished contrast and changes in colour perception

o Mature o Hypermature  Mature and hypermature are final stage where objects no longer describable, bilateral cataract are blind and rely on others for aid • Clinical manifestations: o Disturbance in vision (main) o Gradual loss of clarity with dimness of vision o Progressive myopia caused by increased density of nucleus o Glare or monocular diplopia o If unilateral, may go unnoticed until affects other eye • Diagnosis: o History – v important! o Exam to determine level of visual impairment and detecting possible cause o Dilated fundal examination o If retina not seen, field of vision testing via light waving o Pupil testing for rapd o Us – to exclude retinal detachment o Red reflex test (dilation +ophthalmoscope) • Treatment: o Cataract surgery – elderly patient, nucleus is hard so removed by: • • • •

   

Intracapsular cataract extraction (icce) – obsolete these days Extracapsular cataract extraction (ecce) Phacoemulsification Phacolysis

o Surgical technique chosen depending on • • • • • • •

      

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Aphakia

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Define: Condition where eye lens has been removed so absence of lens e.g. Acquired high hypermetropia Optical condition

Age of patient – icce contraindicated in...