Final Cataract - PPT

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cataract derives from the Latin cataracta
meaning "waterfall" and the Greek kataraktes
and katarrhaktes, from katarassein meaning "to
dash down" (kata-, "down"; arassein, "to
strike, dash").
As rapidly running water turns white, the term

may later have been used metaphorically to
describe the similar appearance of mature ocular
opacities. In dialect English a cataract is called a
pearl, as in "pearl eye" and "pearl-eyed.
 ETIOLOGY
• Gender
• Long-term exposure to ultraviolet light
• “age-related” 40s and 50s
 Immature Senile Cataract (IMSC) - partially
opaque lens, disc view hazy
 Mature Senile Cataract (MSC) - Completely
opaque lens, no disc view
 Hypermature Senile Cataract (HMSC) – lens
protein breakdown into short chain polypeptides
that leak out through the lens capsule. Liquefied
cortical matter: Morgagnian Cataract
• Smoking
• Genetic factors are often a cause of congenital
cataracts and positive family history
 Congenital cataract
• Excessive exposure to radiation coming from
outer space such as Icelandair pilots showed
commercial airline pilots are three times more likely to
develop cataracts than people with non-flying jobs.
 Common in persons exposed to infrared radiation,
such as glassblowers who suffer from "exfoliation
syndrome".
 Exposure to microwave radiation can cause
cataracts.
• Drug induced cataract development, such as
Corticosteroids and Ezetimibe and Seroquel
• Secondary cataract
• Traumatic
 Penetrating trauma (capsular rupture
& leakage of lens material - calls for an
emergency surgery for extraction of lens
and leaked material to minimize further
damage)
• Nutrition-nutritional deficiencies of nutrients
include riboflavin, total protein, amino acids,
vitamin E, vitamin C, selenium, calcium, zinc
 INCIDENCE
According to the World Health
Organization, there are about 42
million blind people in the world; of
which 17 million (40%) are blind due
to cataract. In the Philippines with
the estimated population of 86, 241,
6972 the prevalence rate of persons
with cataract is 1,743,857
 PATHOPHYSIOLOGY
Predisposing factors Precipitating factors

Genetic “age-related” 40s and 50s
Gender Long-term exposure to ultraviolet light
Smoking(35 or more packs/ year) Excessive exposure to radiation
Nutrition Traumatic cataract
Drug induced Secondary cataract
•Corticosteroids •DM
Decrease oxygen uptake in the

lens
Initial increase in water

content
Dehydration of
Increase Na, Ca content
decrease K ascorbic acid
and protein content
Yellowing of the lens due to formation of fluorescent compound

and molecular change
Immature cataract
Mature cataract
Intumescent cataract
If treated: if not treated:
Surgical management: Blindness

• Phacoemulsification,
or phaco.
•Extracapsular surger
•Intra-capsular (ICCE)
surgery
•Intraocular lens (IOL)
Compliance
Good Prognosis
 SIGNS ANG SYMPTOMS
Cloudy or painless blurry vision.
Colors seem faded.
Glare. Headlights, lamps, or sunlight may
appear too bright. A halo may appear around
lights.
Poor night vision.
Double vision or multiple images in one eye.
(This symptom may clear as the cataract gets
larger.)
Vision is better in dim light with pupil dilation
Absence of red reflex
 DIAGNOSTIC EXAMS
1.Visual acuity test

2.Dilated eye exam
3.Tonometry
4.Contrast sensitivity test
5.Visual field test
6.Ophthalmoscopy
• Direct ophthalmoscopy.
• Indirect
ophthalmoscopy..
7.Slit lamp test
8.Glare test
 MEDICAL MANAGEMENT
Prevention
Although cataracts have no scientifically proven prevention, it is
sometimes said that wearing ultraviolet-protecting sunglasses may
slow the development of cataracts. Regular intake of antioxidants
(such as vitamin A, C and E) is theoretically helpful, but taking them
as a supplement has been shown to have no benefit.
Treatment
The symptoms of early cataract may be improved with:
•new eyeglasses
•brighter lighting
•Anti-glare sunglasses or magnifying lenses.
 SURGICAL MANAGEMENT
1.Phacoemulsification, or phaco
2. Extracapsular surgery
3. Intra-capsular (ICCE) surgery
4. Intraocular lens (IOL)
5.YAG laser capsulotomy

Risk of cataract surgery
•Infection and bleeding
• Retinal detachment
•Endophthalmitis
•Posterior capsular opacification
•Inflammation (pain, redness, swelling), loss of
vision, double vision, and high or low eye pressure
• Eye tissue that encloses the IOL becomes cloudy
and may blur your vision. This condition is called an
after-cataract. An after-cataract can develop months
or years after cataract surgery.
Happens before surgery?
•A week or two before surgery, doctor will do

some tests. These tests may include
measuring the curve of the cornea and the
size and shape of your eye. This information
helps the doctor choose the right type of IOL
•may be asked not to eat or drink anything 12

hours before your surgery.
Happens during surgery?
•drops will be put into your eye to dilate the pupil.
•The area around your eye will be washed and
cleansed.
•The operation usually lasts less than one hour and is
almost painless.
•If awake, an anesthetic to numb the nerves in and
around eye.
•After the operation, a patch may be placed over your
eye.
•You will rest for a while.
•medical team will watch for any problems, such as
bleeding. Most people who have cataract surgery can
go home the same day.
•will need someone to drive you home.
Happens after surgery?
•Itching and mild discomfort
•Some fluid discharge
•sensitive to light and touch
•After one or two days, moderate discomfort should
disappear.
•need to wear an eye shield or eyeglasses to help
protect your eye. Avoid rubbing or pressing on your eye.
•When you are home, try not to bend from the waist to
pick up objects on the floor.
•Do not lift any heavy objects. You can walk, climb stairs,
and do light household chores.
•In most cases, healing will be complete within eight
weeks.
 NURSING MANAGEMENT
Sensory/perceptual alteration (visual) related to lens

extraction and replacement
Fear related to upcoming surgery and potential failure attain
improved vision
Acute pain related to increased intraocular pressure
Risk for infection related to increased susceptibility to

surgical interruption of body surfaces
Risk for injury related to visual limitations and presence in

an unfamiliar environment
Pre-op nursing care
1. Instruct measures to prevent or decrease IOP
 Avoid heavy lifting, violent coughing, bending lower the waist, reading (but
watching tv is allowed).
 Avoid prolonged anger and sexual activity
2. Administer pre-op eye medications including mydriatics and cycloplegics
as prescribed. Ex: atropine
Post-op nursing care
1. Elevate the head of the bead 30-45 degrees
2. Turn the client to the back or unoperative side
3. Pharmacologic: antibiotic-steroids
4. No aspirin due to clotting effect
5. Instruct measures to prevent or decrease IOP
6. Wear glasses during the day until the pupils responds to light
7. Eye shield at night or while sleeping
8. For minor pain: ice or heat as prescribed
9. Shower or bathing is allowed
10. Care of the dressings
11. Stool softeners
12. Instruct to report pain with nausea and vomiting.

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C

As rapidly running water turns white, the term

Predisposing factors Precipitating factors

Decrease oxygen uptake in the

Initial increase in water

Yellowing of the lens due to formation of fluorescent compound

Surgical management: Blindness

1.Visual acuity test

3. Intra-capsular (ICCE) surgery

4. Intraocular lens (IOL)

5.YAG laser capsulotomy

•A week or two before surgery, doctor will do

•may be asked not to eat or drink anything 12

Sensory/perceptual alteration (visual) related to lens

Acute pain related to increased intraocular pressure

Risk for infection related to increased susceptibility to

Risk for injury related to visual limitations and presence in

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