Chapter 10. Diseases of the lens Defination of cataract Transparent lens becomes opaque, called cataract VA<0.7 Types of cataract age-related ,congenital , traumatic, diabetic,etc
Age-related cataract Etilogy: risk factors heredity ultraviolet ray systemic disorders(hypertension, diabetes, arteriosclerosis) nourishment condition
Clinical manifestation Bilateral, onset may be early or late, Progressive blurred vision Fixed black spot Monoular diplopia polyplopia
cuneiform tips toward the center, 2. Intumecent stage: Cortical cataract 1. Incipient stage: cuneiform tips toward the center, VA normal, sphenoid shadow, 2. Intumecent stage: opacities develop gradually, swollen iris forward, ant.chamber shallowed,
morgagni’s, milk-like, iridonesis, glaucoma may occur 3. Mature stage: complete opaque 4. Hypermature stage; morgagni’s, milk-like, iridonesis, nucleus fallen down, capscule shrink,
rupture: lens-induced uveitis, phacolytic glaucoma, easy to lead: dislocation of the lens or subdislocation
Nuclear cataract at beginning, lens nucleus appears grey-yelloeish, its color becomes deeper with going near to the center.
Posterior subcapsular cataract Golden yellow or white particles, mixed with small vacules in them occur at shallow layer of subcapsular cortex in posterior pole of the lens. Opacities at visual axis, VA reduce at early stage.
Treatment Surgery 1. Glasses 2. Contact lens 3. ECCE, 4. ICCE, 5. Phaco, 6. IOL implantation
Drug therpy Placibo, antioxidant Vit B2 Vit C Vit E
Question: 1. How to correct aphakia after cataract surgery? 2. How many types of age-related cataract?
Congenital cataract Etiolgy hereity viral infection drug abuse during 1st trimester metabolic disoders during pregnancy
Clinical manifestation 1. Anterior polar cataract 2. Posterior polar cataract 3. Coronary cataract 4. Punctae cataract 5. Perinuclear cataract
6. Nuclear cataract 7. Total cataract 8. Membranous cataract 9. Suture cataract
Diagnosis & Treatment Easy to diagnose Surgery: aspiration correction after surgery: 1.Glasses 2.Contact lens 3.IOL implantation
Traumatic cataract Etiology 1. Contusion 2. Penetrating 3. Explosive 4. Electric
Diabetic cataract Complicated cataract Toxic cataract After-cataract Dislocation or sublislocation