CATARACT

An opacity of the eye lens that

distorts the image projected onto the
retina.
ETIOLOGY
 Cataracts are classified by nature or timing of onset.
May be present at birth or develop later.
 Associated with:
>Age
>Trauma
>Systemic illnesses eg Dm
>Exposure to toxic chemicals eg radiation and UV light
>Systemic drugs eg long term use of corticosteroids
>Ocular diseases eg glaucoma
TYPES OF CATARACTS

1.Subcapsular cataract-occurs at the back of the

lens. Pple with diabetes or those taking high
doses of steroids are at high risk.
2.Nuclear cataract-forms deep in the central zone
of the lens. Usually associated with aging.
3.Cortical cataract-occurs in the periphery of the
lens (cortex ) working their way to the centre in
a spoke-like fashion
MANIFESTATION
 Early symptoms:
*Blurred vision
*Decreased color perception
 Late symptoms:
*Diplopia
*Reduced visual acuity progressing to
blindness
*Absence of red reflex
MANAGEMENT
 Cataract surgery-done when there is
significant functional impairment from poor
vision. They include:
1. Phacoemulsification-modern cataract surgery
2. Extra capsular cataract extraction (ECCE)
3. Manual small incision cataract (MSIC)
4. Intracapsular cataract extraction (ICCE)
PRE-OP CARE
 Client education
 Oral acetazolamide given on the morning of
surgery to reduce intraocular pressure
 Sympathomimetics eg phenylephrine are
instilled to achieve mydriasis and
vasoconstriction .
 Parasympatholytic drops eg tropicamide to
induce paralysis and render the ciliary muscles
unable to move the lens.
 Discuss rehabilitation options ie eyeglasses,
contact lenses, intraocular lens.
POST-OP CARE
 Immediately after, antibiotic drops eg gentamycin or
maxitrol( with steroid)
 Cover eye with an eye patch or protective shield
 Client placed in semi-fowler’s position
 Observe dressing for drainage
 Vital signs observation
 Analgesics for pain. Investigate the cause of pain
especially if accompanied by nausea and vomiting.
 Eye protection after eye patch removal ie glasses or
sun glasses worn during the day and a protective
shield at night.
CONT’

 Prevention of complications:
1. Increased intraocular pressure
2. Infection
3. Bleeding from anterior chamber of the
eye
4. Retinal detachment