Cataracts: Difference between revisions
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* By age 80 approximately 50% of Americans have been diagnosed with one or more cataracts<sup>[1]</sup> | * By age 80 approximately 50% of Americans have been diagnosed with one or more cataracts<sup>[1]</sup> | ||
* Additional risk factors for cataract include Diabetes, smoking, prolonged exposure to sunlight, and alcohol use<sup>[1]</sup><sup>[2]</sup> | * Additional risk factors for cataract include Diabetes, smoking, prolonged exposure to sunlight, and alcohol use<sup>[1]</sup><sup>[2]</sup> | ||
* A cataract is typically a non-emergent pathology which can be managed with outpatient ophthalmologic surgery on a routine basis. | |||
==Clinical Features== | ==Clinical Features== | ||
| Line 18: | Line 19: | ||
* Decreased visual acuity | * Decreased visual acuity | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
==Evaluation== | ==Evaluation== | ||
===Workup=== | ===Workup=== | ||
Eye Examination<sup>[3]</sup> | |||
* Visual Acuity | |||
* Pupillary Examination | |||
* Intra-ocular Pressures | |||
* Extra-ocular motility and alignment | |||
* Confrontation Visual Fields | |||
* External Examination | |||
* Slit lamp examination | |||
* Fundoscopic examination | |||
An ophthalmologist will be capable of doing a dilated eye examination, which can aid in the diagnosis and classification of cataract. | |||
Note: If a cataract is suspected to be secondary to trauma, a full neurologic examination and traumatic surgery should be done. | |||
===Diagnosis=== | ===Diagnosis=== | ||
* The diagnosis of cataract is based on the findings of lens opacity on direct ophthalmic examination. | |||
* Cataracts are typically classified using the lens opacities classification system. | |||
* Cataracts can be classified as nuclear, cortical, or posterior sub-capsular, however characterization of cataract is typically done by an ophthalmologist. | |||
==Management== | ==Management== | ||
* The definitive treatment for a cataract is outpatient surgical management with an Ophthalmologist | |||
* During a cataract surgery, the patient's cloud lens is removed, and it is replaced with a clear, artificial lens for the eye. | |||
Other supportive care modalities that help with visual symptoms include:<sup>[1]</sup> | |||
* Using brighter lights while at work or at home | |||
* A trial of anti-glare suncglasses for outdoor activities | |||
* Using magnifying lens glasses for reading and other daily | |||
==Disposition== | ==Disposition== | ||
If the diagnosis of cataract is made, the usual disposition is outpatient followup with an ophthalmologist within 1-2 weeks to discuss the potential for surgical management. | |||
==See Also== | ==See Also== | ||
==External Links== | ==External Links== | ||
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts | https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts | ||
https://www.aao.org/young-ophthalmologists/yo-info/article/how-to-conduct-eight-point-ophthalmology-exam | |||
==References== | ==References== | ||
<references/> | <references/> | ||
[1] National Eye Institute, "Cataracts | [1] National Eye Institute, "Cataracts" <https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts>, accessed 16 Dec 2020 | ||
[2] West SK, and Valmadrid CT, "Epidemiology of risk factors for age-related cataract," Surv Ophthalmol. 1995;39(4):323. | [2] West SK, and Valmadrid CT, "Epidemiology of risk factors for age-related cataract," Surv Ophthalmol. 1995;39(4):323. | ||
[3] American Academy of Ophtalmology, "The 8-Point Eye Exam" <https://www.aao.org/young-ophthalmologists/yo-info/article/how-to-conduct-eight-point-ophthalmology-exam>, accessed 16 Dec 2020 | |||
Revision as of 19:57, 16 December 2020
Background
- A cataract is opacification in the lens of one or both eyes which can lead to decreased visual acuity and visual distortions
- Cataracts are most commonly due to normal age related changes, however they can also be caused by eye trauma, exposure to sunlight or radiation, malnutrition, corticosteroid use, and other pathologic processes
- By age 80 approximately 50% of Americans have been diagnosed with one or more cataracts[1]
- Additional risk factors for cataract include Diabetes, smoking, prolonged exposure to sunlight, and alcohol use[1][2]
- A cataract is typically a non-emergent pathology which can be managed with outpatient ophthalmologic surgery on a routine basis.
Clinical Features
History
- Cloudy or blurry vision
- Difficulty with night time vision
- Colors appear faded
- Appearance of a halo around bright lights
- Recent trauma to the eye
Exam Findings
- Lens opacity on ophthalmic examination
- Darkening of the red reflex
- Decreased visual acuity
Differential Diagnosis
Evaluation
Workup
Eye Examination[3]
- Visual Acuity
- Pupillary Examination
- Intra-ocular Pressures
- Extra-ocular motility and alignment
- Confrontation Visual Fields
- External Examination
- Slit lamp examination
- Fundoscopic examination
An ophthalmologist will be capable of doing a dilated eye examination, which can aid in the diagnosis and classification of cataract.
Note: If a cataract is suspected to be secondary to trauma, a full neurologic examination and traumatic surgery should be done.
Diagnosis
- The diagnosis of cataract is based on the findings of lens opacity on direct ophthalmic examination.
- Cataracts are typically classified using the lens opacities classification system.
- Cataracts can be classified as nuclear, cortical, or posterior sub-capsular, however characterization of cataract is typically done by an ophthalmologist.
Management
- The definitive treatment for a cataract is outpatient surgical management with an Ophthalmologist
- During a cataract surgery, the patient's cloud lens is removed, and it is replaced with a clear, artificial lens for the eye.
Other supportive care modalities that help with visual symptoms include:[1]
- Using brighter lights while at work or at home
- A trial of anti-glare suncglasses for outdoor activities
- Using magnifying lens glasses for reading and other daily
Disposition
If the diagnosis of cataract is made, the usual disposition is outpatient followup with an ophthalmologist within 1-2 weeks to discuss the potential for surgical management.
See Also
External Links
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts
References
[1] National Eye Institute, "Cataracts" <https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/cataracts>, accessed 16 Dec 2020
[2] West SK, and Valmadrid CT, "Epidemiology of risk factors for age-related cataract," Surv Ophthalmol. 1995;39(4):323.
[3] American Academy of Ophtalmology, "The 8-Point Eye Exam" <https://www.aao.org/young-ophthalmologists/yo-info/article/how-to-conduct-eight-point-ophthalmology-exam>, accessed 16 Dec 2020