Teresita, age 57 and a married Filipino, was admitted to the hospital due to complaints of

blurring vision and headache. She is a Roman Catholic and lives in General Santos City. Upon

admission, the patient revealed that she has been wearing eyeglasses since she was 16 years old

to correct her myopia and astigmatism. In the year 2017, the patient reported that she had been

experiencing blurry vision and headaches for about 3 months. Thinking that she needed to get

her eyeglasses checked, the patient went to her eye center. Upon examination, the optometrist

stated that she was having difficulty finding the correct eye grade of the patient and was advised

to go to an opthalmologist. However, the patient just wanted to get her eyeglasses changed

because she hoped that this would make her vision clearer since blurry vision and headache were

her indications in the past that she needed to change her eyeglasses. Hence, she did not think

much about her situation. 

After two years, in the year 2019, the patient was still experiencing the same symptoms.

As a result, the patient decided to go to another eye center to get her eyes checked. At the eye

center, the optometrist said that they will not change the eyeglasses of the patient unless the

patient will have a prescribed eye grade coming from an opthalmologist. In December of the

same year, the patient finally decided to go to an opthalmologist, Dr. Villanueva. The patient was

checked and it was found out that the patient had cataracts on both eyes and was advised for an

operation after 6 months. The physician also prescribed Pirenoxine, an eye drop, to the patient to

be instilled 3x a day and 1 drop per instillation. Despite the physician’s advice to have a surgical

operation on June 2020, the patient decided not to go through with the procedure due to fear.

Instead, the patient decided to use other herbal eye drops with the hope of being treated without

getting surgery. 
 In 2021, the patient continued to experience deteriorating vision. Hence, she decided to

seek a second opinion from another ophthalmologist, Dr. Atendido. During her check-up, she

was diagnosed with a senile mature cataract on both eyes and was advised for an immediate

operation. The physician prescribed Sodium Chloride eye drops to be instilled 3x a day with 1

drop per instillation and a food supplement, Eye-Vites Max, to be taken once a day until the

operation. The patient still decided to delay her operation due to fear. 

This year, the patient reported that her blurry eyesight has already interfered with her

daily living. She cannot read and write without assistance. She also cannot cross the road alone

because she cannot clearly see the moving vehicles. In general, she reported feeling isolated and

having less independence because of her eye condition. As a result, she decided to have the

surgery and admitted herself to the hospital. 

The patient was admitted on September 12, 2022, at 8:30 AM with her physician, Dr.

Atendido. The patient reported that her mother also had a senile cataract but was untreated. All

of her family members also wore eyeglasses due to myopia and astigmatism. The patient and her

family also have a history of hypertension. She has been taking her maintenance for

hypertension, Losartan, twice a day. The patient has no history of smoking, alcohol use, and

allergies. The patient also denies any recent illness aside from her chief complaints. The patient

was accompanied by her sister. 

A physical exam was performed on the patient. The visual acuity of the patient has

declined bilaterally. The visual acuity of the patient was as follows: OD was 20/70 and OS was

20/50. The patient had normal appearing orbital structures on both sides. No nystagmus was

noted. Upon optical examination, the lens was dark brown with an iris shadow. No fundal view

due to dark opacity in the center against a red glow. No fourth Purkinje image. 
 The patient was awake and interactive. She responded appropriately to questions and

provided information accurately. The patient, however, stated her fears about the procedure. The

blood pressure of the patient was taken and the results were 150/90 mmHg. 

Before the surgery, the patient underwent a biometry test. An RT-PCR test was also

administered which tested negative. CBC was performed and the results were normal. A chest x-

ray also revealed a normal lungs. The patient was put under local anesthesia through IV. The

surgery started at 11:38 AM and ended at 12:08 PM. The surgeon noted stab incisions,

capsulorrhexis, phaco done, and IOL inserted. Medications prescribed were Vigamox eye drops,

Pred Forte eye drops, NaCl eye drops, Ciprofloxacin, Acetazalamide, and Kalium Durules. 

Post-operatively, the patient reported clearer vision with halos when looking at lights,

discomfort in the eyes, and having a “heavy” feeling in the eyes.