Definition
- A cataract is a disorder in which opacity (cloudiness) in the lens of the eye and degeneration of lens fibers, lead to blurred vision.
- A cataract occurs due to hydration, denaturation of lens protein, and sclerosis.
-
A cataract is the most common cause of blindness.
Cataract classification
-
According to etiology
-
Acquired cataract
- Acquired cataracts commonly occur.
- Acquired cataract are
- Senile cataract
- Metabolic cataract
- Complicated cataract
- Traumatic cataract
-
Cataracts
associated with skin disease
- Drug Induced cataract
- Cataract with miscellaneous syndrome
- Electric cataract.
-
Developmental cataract
- Also known as the congenital cataract occurs due to disturbance in normal development of the lens.
- Generally development cataracts occur in the infancy to adolescence, due to genetic disorders.
2. According to morphology
- Subcapsular cataract – anterior subcapsular cataract.
- Posterior subcapsular cataract.
-
Cortical cataract –
a cataract occurs due to wedge shape or radial spoke like opacities of lens.
- Occur outer edge of the lenses.
-
Nuclear cataract –
a cataract occurs in the center of the lens.
- Yellow to Brown coloration.
Causes of Cataract
- Hereditary
- Family history
- Age factors
- Malnutrition during pregnancy
- Radiation exposure
- Excessive use of corticosteroids
- Down syndrome
- Skeletal syndrome
- Chromosome abnormality
- Birth trauma
- Infection
- Diabetes mellitus
- Trauma
- Marfan syndrome
- Previous ocular surgery
- Wilson disease.
Pathophysiology of Cataract
Cause / Etiology
↓
Traumatic damage the lens fibres
↓
Rupture lens capsule
↓
Hydration of lens fibers
↓
Opacity of lens.
Signs/Symptoms of Cataract
Clinical manifestation of
Cataract Clinical manifestation
- Cloudy vision
- Blurred vision
- Photophobia ( sensitive to light )
- Double vision
- Monocular diplopia
- Glare
- Distortion of lines
- Reduce visual acuity
- Dim red reflex
- Poor vision at night
- Decrease colour perception
- White pupil.
Diagnostic examination of Cataract
- History collection and physical examination.
- Direct ophthalmoscope examination.
- Snailing visual acuity test.
- Slit lamp examination.
- Tonometry.
- Retinal examination.
Medical management of Cataract
- Use glasses
- Optical aids
- Pupillary dilation
- Topical steroids
- Antibiotics drops
- Steroid drops.
Surgical management of Cataract
- Intracapsular extraction – remove the whole lens and surround it.
- Extracapsular extraction – only cataract removal.
- Cryosurgery
- Phacoemulsification – emulsifying of the lens by a hollow needle vibrating and ultrasonic speed.
Complication – Blindness.
Nursing management
- Nurses monitor patients’ visual acuity and vital signs.
- Examine the complete morphology of lens opacity under slit lamp examination.
- Examine the cornea to find out any opacity of the lens.
- Monitor intraocular pressure (IOP).
- Nurses also assess pupillary response.
- The nurse performed the cover test.
- Use a nursing barrier to prevent infection.
- Nurses assist the client during any activity.
- Provide instruction about cataract patient care and Management.
- Nurses help to conduct diagnostic examinations.
- Provide adequate medications and other required treatment.
- Provide emotional and physiological support and reduce anxiety.
- Prepare the client for surgical intervention.
- Administer local anesthesia with sedation before surgery.
- Nurse counseling to relieve patient anxiety.
What is the main cause of cataracts?
Hereditary
Family history
Age factors
Malnutrition during pregnancy
Radiation exposure
Excessive use of corticosteroids
Down syndrome
Skeletal syndrome
Chromosome abnormality
Birth trauma
Infection
Diabetes mellitus
Trauma
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