No eye pain or redness unless lens-induced glaucoma or uveitis
- Cataract is permanent opacity of the lens
- May be congenital or acquired
- Globally, untreated cataract is the most common cause of visual
- The lens thickens and opacifies with age
- Cataract detected in > 50% over the age 65
- Increasing age, Diabetes, Family history
- Steroid use, UV light, radiation
- Congenital : TORCH infection, Galactosaemia
- Wilson’s disease: ‘sunflower’ cataract.
- Hypertension, Smoking, Dystrophia myotonica
- Radiation UV exposure, Uveitis
Classification of different types
- Nuclear - central seen in old age
- Polar - localised seen in inherited disorders
- Subcapsular - related to steroid use
- Dot - Diabetes
- Gradual loss of vision, Blurred vision, Glare
- Haloes around lights, Changing refractive index
- Loss of red reflex
- Children - amblyopia, squint, nystagmus
- Blood sugar to exclude diabetes
- Screen for Wilsons disease in selected cases
- Consider assessing and managing refractive errors and if not benefit then consider surgery.
- Ophthalmology referral for day-case surgical incision and ultrasonic phacoemulsification with intraocular
lens (IOL) implant. under local anaesthesia and sedation such as Midazolam/Propofol. Anticoagulation can often be continued.
- Operative complications: Infection, Posterior capsule rupture, vitreous haemorrhage, Glaucoma, Posterior capsule thickening and opacification which can be treated with laser therapy.
- Optimise diabetic management. Avoid steroids.