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Unit II Cataract

Unit II Cataract. Presented by Hezil Reema Barboza. Learning objectives. At the end of class learner will be able to define cataract list the types of cataract describe the clinical features and diagnostic findings of cataract explain the surgical and nursing management of cataract.

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Unit II Cataract

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  1. Unit IICataract Presented by HezilReemaBarboza

  2. Learning objectives At the end of class learner will be able to • define cataract • list the types of cataract • describe the clinical features and diagnostic findings of cataract • explain the surgical and nursing management of cataract

  3. CATARACT

  4. ETIOLOGY: • EYE INJURY • SUN EXPOSURE • SMOKING • HYPERTENSION • KIDNEY DISORDERS • DIABETES MILLETUS • LONG TERM USE OF STEROIDS • TOXIC SUBSTANCES • HEREDITARY

  5. PATHOGENESIS: • DEGENERATION • OPACIFICATION • DEPOSITION OF OTHER MATERIAL • ABNORMALITY OF LENS PROTEIN • DISORGANISATION OF FIBRES

  6. SYMPTOMS: • Blurred vision   • Trouble in driving at night (Glare)  • Sensitivity to bright light  • Change in color vision • (yellow, orange, and red appear brighter and WHITE appears dull). • Polyopia ( several images of same object) and monocular diplopia • Coloured haloes

  7. Blurred vision due to scattering of light on the retina

  8. Blurred vision

  9. CHANGE IN COLOUR VISION(DIMNESS)

  10. CLASSIFICATION : • BASED ON : • MORPHOLOGY • AGE OF ONSET • MATURITY • ETIOLOGY

  11. Morphology 1.Capsular cataract -Anterior capsular cataract -Posterior capsular cataract 2.Sub capsular cataract -Anterior subcapsular cataract -Posterior subcapsular cataract 3.Nuclear cataract 4.Cortical cataract

  12. 5.Lamellar/zonular cataract 6.Sutural cataract

  13. Capsualar cataract: one consisting of an opacity of the capsule of the lens

  14. A subcapsular cataract occurs at the back of the lens

  15. Nuclear Cataracts that affect the center of the lens

  16. Cortical cataracts usually start on the outside of the cortex (the outer area of the lens).

  17. Lamellar/zonular cataract This type of cataract is bilateral. It can be congenital or it can be acquired during the first years of life due to tetany or rickets.

  18. Sutural cataracts are congenital lens opacities that affect the Y sutures of the nucleus of the fetal lens

  19. Age of onset: 1.Congenital 2.Infantile 3.Juvinile 4.Pre-senile 5.Senile

  20. Congenital cataract A congenital cataract is a clouding of the lens of the eye that is present at birth.

  21. Infantile and juvenile cataract Infantile or juvenile cataracts – cataracts diagnosed in older babies or children.

  22. Senile cataract is an age-related, vision-impairing disease characterized by gradual progressive thickening of the lens of the eye.  • Pre-senile: Opacity of the lens or capsule of the eye, causing impairment of vision or blindness.

  23. Maturity: 1.Intumescentcataract 2.Immature cataract 3.Mature cataract 4.Hypermature cataract 5.Morgagnian cataract

  24. Intumescent cataract • Intumescent cataract a mature cataract that  progresses; the lens becomes swollen from the osmotic effect of degenerated lens protein, and this may lead to secondary angle closure (acute) glaucoma

  25. Immature cataract: the lens is only slightly opaque and the  • cortex clear

  26. Mature cataract: a cataract that produces swelling and opacity of  the entire lens; cataracts are removed before maturity.

  27. In a hypermature or Morgagnian cataract, the lens proteins have become liquid.

  28. A morgagnian cataract is a hypermature cataract in which the total liquefaction of the cortex has allowed the nucleus to sink inferiorly.

  29. Etiologic: • Traumatic cataract • Metabolic cataract • Toxic cataract • Complicated cataract • Intra uterine cataract • Heriditary cataract • Radiational cataract • Electric cataract

  30. Clinical features • Decreased vision • Abnormal color perception • Glare

  31. Diagnosis

  32. Slit lamp examination

  33. Non surgical therapy • Change of glasses • Strong reading glasses • Lifestyle adjustment • reassurance

  34. Surgical therapy • Removal of lenses Phacoemulsification Extracapsular extraction 2. Correction of surgical aphakia 3. Intraocular lens implantation 4. Contact lenses

  35. Phacoemulsification

  36. Phacoemulsification is a modern cataract surgery in which the eye's internal lens is emulsified with an ultrasonic handpiece and aspirated from the eye. • Aspirated fluids are replaced with irrigation of balanced salt solution to maintain the anterior chamber.

  37. Extracapsular extraction

  38. Extracapsular cataract extraction (ECCE) is a category of eye surgery in which the lens of the eye is removed while the elastic capsule that covers the lens is left partially intact to allow implantation of an intraocular lens

  39. Contact lenses

  40. Pre operative phase • Pre operative antibiotic eyedrops • NPO 6-8 hours • Instillation of dilating drops- mydriatics and cycloplegics • Non steroidal anti inflammatory eyedrops

  41. Post operative phase • Antibiotic drops • Corticosteroid drops • Night time eye shielding • Avoid activities such as bending , coughing, lifting

  42. Summary • A cataract is a cloudy area that forms in the lens of the eyes. • It develops slowly and eventually interferes with the vision. • Cataract are most common in older people

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