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Cataract

Cataract is the opacity and cloudiness of lens and it is responsible for vision disability. Cataract is the leading cause of blindness worldwide.

Classification:-

There are three types of cataract 
1. Traumatic
2. Congenital
3. Senile cataract


Risk factors :-

Cataract is depend on several factors for formation.

1. Age
-loss of lens transparency due to increased age
- increase in sodium and calcium levels
- Decreased oxygen uptake
- clumping and aggregation of lens protein
- Decreased in level of vitamin c, protein and glutathione
- accumulation of yellow brown pigment due to lens breakdown.

2. Ocular condition

- infection
- myopia
 - Retinal detachment
 -  Retinitis 

3. Toxic factors

- Alkaline chemical eye burns 
- poision 
- use of Aspirin
- calcium , copper , iron , gold ,silver and Mercury 
- cigarette smoking
- ionising radiation
- corticosteroid

4. Nutritional Factors

- obesity
- poor nutrition
- Reduced levels of antioxidants


5. Physical Factors

- ultraviolet rays in sunlight and x-ray 
- Blunt trauma 
- perforation of lens with a sharp object or foreign body, electric shock
- Dehydration associated with chronic diarrhoea.


6. Systemic Disease 

- Diabetes
- Disorders related to lipid metabolism
- Down syndrome
- Renal disorders
- musculoskeletal disorders


Clinical manifestations:-

1. Painless , blurry vision
2. Light scattering is common
3. Sensitivity to glare
4. Decreased visual acuity
5. Myopia
6. Monocular diplopia
7. Astigmatism


Diagnosis:-

1. Snellen visual acuity test
2. Ophthalmoscopy
3. Slit lamp biomicroscopy 
4. Checking visual acuity

Management :-

1. Medication
2. Eye drops 
3. Eyeglasses
4. Sugar levels control for patients with diabetes

Surgical management :-

Surgery is performed on an outpatient basis and usually takes less than 1 hour with the patient being discharged in 30 minutes or less afterward.

If both eyes have cataract one eye is treated first , with atleast several weeks , preferably months , separating the two procedure.

Phacoemulsification

In this cataract surgery a portion of anterior capsule is removed , allowing extraction of the lens nucleus and cortex while the posterior capsule and zonular support are left intact.
An ultrasonic device is used to liquefy the nucleus and cortex , which are then suction out through tube . An intact zonular capsule diaphragm provide the needed safe anchor for the posterior chamber IOL. 

The surgeon makes a small incision on the upper edge at the cornea and a viscoelastic substance is injected into between the space of cornea and lens.
This step prevent from collapsing and facilities insertion of the IOL.


Lens replacement 

The lens, which Focuses light on the retina , must be replaced for the patient to see clearly . There are three lens replacement options :- aphakic eyeglasses , contact lenses and IOL implants .

Thanks for reading 
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