CATARACT SEMINAR PRESENTATION WITH PATHOPHYSIOLOGY

Cataract introduction
Cataract definition
Cataract causes
Cataract incidence
Cataract management
Cataract complications
Cataract anatomy

1. PRESENTATION ON CATARACT

2. CATARACT
INTRODUCTION :-
A cataract is a cloudy area in the lens of your eye (the
clear part of the eye that helps to focus light). Cataracts
are very common as you get older.
A condition in which the lens of the eye becomes cloudy.
Symptoms include blurred, cloudy, or double vision, and
difficulty seeing at night. Without treatment, cataracts can
cause blindness.

3. DEFINITION
- ACCORDING TO WHO
A cataract is a disease of the eye in which the normally clear
lens has pacified, which obscures the passage of light.

4. - According to medical dictionary
A cataract is a clouding or opacity that develops in the
lens of the eye, varying in degree from slight to complete
opacity and obstructing the passage of light.

7. EPIDEMOLOGY

8. INCIDENCE
❑Almost one in five people between the
ages of 65 and 74 develop cataract
severe enough to reduce vision.
❑The annual incidence of cataract
blindness in India is approximately
3.8 million.
❑ The survey also found that 80.1%
of the 12 million blind people in
India are blind due to cataracts.
3.8
million
annual
incidence

9. -The three most common types based on
morphology :-
1.Nuclear Cataract
located in the center of the lens. The nucleus tends to
darken changing from clear to yellow and sometimes
brown.
2.Cortical Cataract
Affects the layer of the lens surrounding the nucleus.
The cataract looks like a wedge or a spoke.
3. Subcapsular cataract
It involves superficial part of the cortex(just below the
capsule) and includes anterior sub capsule or posterior
subcapsule.
CLASSIFICATION

10. Nuclear Cataract
Cortical Cataract
Subcapsular cataract
TYPES

11. CLASSIFICATION OF CATARACT
According to etiology
▪Congenital cataract
▪Infantile cataract
▪Juvenile cataract
▪Presenile cataract
▪Senile cataract
▪Traumatic cataract
▪Metabolic cataract
▪Toxic cataract
▪Intrauterine cataract
▪Hereditary cataract

12. Old age
(commonest)>65 Year•
Ocular & systemicdiseases
– DM
– Uveitis
– Previous ocular surgery
• Systemic medication
– Steroids
– Phenothiazines•
Trauma & intraocularforeign
bodies
• Ionizing radiation
– X-ray, UV
Congenital
– Part of a syndrome
– Abnormal galactose
metabolism
– Hypoglycemia
• Inherited abnormality
– Myotonic dystrophy
– Marfan’s syndrom
– Rubella
– High myopia
❑CAUSES

13. OTHER RISK FACTORS-
Smoking
Eye injuries
Alcohol consumption
UV exposure
Family history

14. Any physical or chemical cause
↓
Disturbs the intracellular and extracellular equilbrium of
water and electrolytes
↓
Deranges the colloid system in lens fibres
↓
Aberrant fibres are formed from germinal epithelium of
lens
↓
Epithelial cell necrosis
↓
Focal opacification of lens epithelium(glaucomflecken)
↓
Opacification of lens
PATHOPHYSIOLOGY

15. CLINICAL MANIFESTATION

16. Blurred vision. Blurred vision is usually the
first symptom of cataracts.
Glare. Glare refers to the pain felt when the
patient looks directly into the light.

17. Halos. Halos are formed when the patient looks at a
bright light and there is still the vision of the light
after looking away
Double vision. Double vision is also one of the
early symptoms of cataract.

18. DIAGNOSTIC EVALUATION
● History Taking
● Physical Examination
● Visual Acuity Measurement

19. ● Physical Examination

20. ● Visual Acuity Measurement
The visual acuity test is used to determine the smallest letters you can
read on a standardized chart (Snellen chart) or a card held 20 feet (6
meters) away.

21. Cont….
● Slit Lamp Microscopy
● Glare Testing
● Ophthalmoscopy

22. ● Slit Lamp Microscopy
A slit-lamp, which is a specialized magnifying microscope, is used
to examine the structures of the eye (including the cornea, iris,
vitreous, and retina).

23. ● Glare Testing
Glare testing is used to
measure the amount of
vision loss caused by
cataracts. The test involves
having the patient look at a
bright light and
determining the level of
difficulty they have with the
task. This helps to assess
the severity of the cataracts
and decide on the best
course of treatment.

24. ● Ophthalmoscopy
Ophthalmoscopy is an
examination of the back part of
the eye (fundus), which
includes the retina, optic disc,
choroid, and blood vessels.
Ophthalmosco
pe

25. MANAGEMENT
OF CATARACT

26. Medical Management
No nonsurgical treatment cures cataracts or prevent
age-related cataracts.
Ongoing studies are investigating ways to slow
cataract progression, such as intake of antioxidants (e.
g., vitamin C, vitamin E)
In the early stages of cataract development, glasses,
contact lenses, strong bifocals, or magnifying lenses
may improve vision.

27. ❖Dilating drops- Dilating drops are administered
every 10 minutes for four doses at least 1 hour before
surgery.(cyclopentolate)
Pharmacological Management
•Medications administered pre and postoperatively are:
❖ Antibiotic drugs. Antibiotic drugs may be
administered prophylactically to prevent
postoperative infection and inflammation.(Ofloxacin)
❖Anti-inflammatory-An anti-inflammatory that you
should use one drop in your operative eye once a day at
bedtime. (Moxifloxacin)

28. Moxifloxacin
Route – eye instillation
Dose – 2 drops
Action – reduce inflammation
indication – acute sinusitis , bacterial conjunctivitis
Contra indication – ischemia / pregnancy
Side effect – dizziness , nausea
cyclopentolate
Route – topical
Dose – 1 -2 drops
Action – mydriatic
indication – mydriasis
Contra indication –glaucoma
Side effect – fever , dry mouth, hyportension

29. ▪Aspirin
Route – Oral
Dose – 325 mg
Action –salicylate (pain relief)
indication –acute rheumatic fever , arthritis
Contra indication – bleeding ,vitamin k
deficiency
Side effect – dizziness , confusion ,vision loss

30. ❖Intracapsular cataract extraction. This procedure
removes the entire lens within the intact capsule.
Surgical Management
•Common surgical procedures done to correct cataracts:
❖ Extracapsular cataract extraction (ECCE). ECCE
removes the anterior lens and cortex, leaving the
posterior capsule intact.
In either extra capsular surgery or intra capsular surgery,
the cataractous lens is removed and replaced with a
plastic lens which stays in the eye permanently.

32. ❖Phacoemulsification – It is a surgery used to
restore vision in people with cataracts, or clouding
of the eye's lens. This type of cataract surgery uses
ultrasonic waves to break the lens into tiny pieces,
which are then suctioned out of the eye with a
vacuum. The procedure is completed by replacing
the damaged lens with an artificial one.

33. Phacoemulsification

34. ❖Assess visual acuity
❖Give accurate information
❖ Administer eye medications
❖Elevate the head of the bed 30 to
45degrees.
❖Notify the surgeon
NURSING MANAGEMENT

35. NURSING DIAGNOSIS
▪Acute pain related to trauma to the incision and
increased IOP as evidence by patient verbalization.
▪Anxiety related to lack of knowledge as evidenced by
verbalization of anxious questions.
▪Self –care deficits related to visual deficit as
evidence by decreased vision acuity
▪Risk for infection related to surgical incision and
self care after surgery.
▪Risk for injury related to sensory deficit while operated
eye is patched

36. COMPLICATIONS
oPosterior Capsule Opacity (PCO)
oIntraocular Lens Dislocation
oEye Inflammation
oLight Sensitivity
oMacular Edema
oPtosis
oOcular Hypertension

37. PREVENTION
▪Don’t smoke. Tobacco smoke raises your risk
of cataracts. If you currently smoke, ask a
healthcare provider for resources to help you
quit.
▪Protect your eyes from the sun. Wear
sunglasses or eyeglasses with an anti-UV
coating. A hat with a brim can also help.
▪Get regular eye care. Ask your provider how
often you should come in for checkups.

38. HEALTH EDUCATION
❑Avoid Eye Straining
❑Avoid Rubbing
❑Avoid Rapid Movement
❑Proper Hygiene And Eye Care Techniques
❑Use Eye Shield At Bedtime
❑Follow-up As Recommended

39. ANY
QUESTIONS?

40. THANKYOU
TODAY A READER TOMORROW A LEADER