cataract is clouding of the lens inside the eye.. it is very useful topic in medical filed...in this presentation all content is included about cataract like causes, symptoms and treatment...its very useful in your study.

2. CATARACT
BY-
PREETI SHARMA
MSC. NSG. 1ST YR.

3. INTRODUCTION
A cataract is a clouding of the lens inside
the eye which leads to a decrease in vision.
Cataracts are the most common cause of vision
loss in people over age 60 and are the principal
cause of blindness in the world. In fact, there are
more cases of cataracts worldwide than there are
of glaucoma, macular degeneration and diabetic
retinopathy.

4. DEFINITION
“A cataract is a clouding or opacity within the
crystalline lens that leads to gradual painless
blurring and eventual loss of vision. The patient
may have a cataract in one or both eyes. If
present in both eyes, one cataract may affect the
patient’s vision. The cataracts are third leading
cause of preventable blindness.”

5. ANATOMY AND PHYISOLOGY
OF EYE

6. TYPES
CONGENITAL
ACQUIRED
SENILE
CORTICAL
SENILE
NUCLEAR
TRAUMATIC
CATARACT
PATHOLO-
GICAL
CATARAC
T
CLASSIFICATION

7. Congenital Cataract- It present at birth or form
during a baby’s first year, are less common than
age related cataracts.
Acquired Cataract- It is 4 types:
Senile Cortical- Cortical cataracts are wedge
shaped and form around the edges of the nucleus.
Senile Nuclear- Nuclear cataracts form in the
middle of the lens and cause the nucleus, or the
centre, to become yellow or brown.

8. CONT...
Traumatic cataract- It develops after an injury
to the eye, but it can take several years for this to
happen.
Pathological Cataract- It develops after any
disease of the eye

9. RISK FACTORS
• Age: The incidence increases dramatically after the
age of 6o.
• Sex: Cataracts are slightly more common in women
than men.
• Ultraviolet light exposure:
– More common in persons living in warm
sunny climates.
• Drug effects: Use of corticosteroids, Phenothiazines
and selected chemotherapeutic agents.
• Poorly-controlled diabetes mellitus accumulation of
Sorbitol (by product of glucose).
• Trauma to the eye.

10. ETIOLOGY
Degenerative changes- Senile cataracts develop in
elderly patients, probably because of the degenerative
changes in the chemical state of lens proteins.
Genetic defects- Congenital cataracts occur in neonates
genetic defects or as a sequel of maternal infections
during the first trimester.
Foreign body injury- Traumatic cataracts occur after a
foreign body injures the lens with sufficient force to
allow aqueous or vitreous humor to enter the lens
capsule and also dislocate the lens

11. Secondary effects- Complicated cataracts occur
as secondary effects in patients with uveitis,
glaucoma, or retinitis pigmentosa, or in the
course of a systemic disease, such as diabetes,
hypoparathyroidism, or atopic dermatitis.
Drug or chemical toxicity- Toxic cataracts
result from drug or chemical toxicity with
prednisone, ergot alkaloids, dinitrophenol,
naphthalene, phenothiazines, or pilocarpine, or
from extended exposure to ultraviolet rays

12. PATHOPHYSIOLOGY
Due to etiological factors
Lens consist of 65% of H2O & 35% of protein
and minerals
Formation of new proteins
Protein amount of lens increase & clumps to old
proteins of lens

13. Clumps compacted into centre of lens
Cloudens the lens
Prevents lights from passing clearly leading to
blurred vision & blindness

14. CLINICAL MANIFESTATION
• Blurred vision- Blurred vision is usually the first
symptom of cataracts.
• Glare- Glare refers to the pain felt when the
patient looks directly into the light
• Halos- Halos are formed when the patient looks
at a bright light and there is still the vision of the
light after looking away.
• Double vision- Double vision is also one of the
early symptoms of cataract.
• Maternal Malnutrition- Develops congenital
cataract.

15. Coagulation of protein- Cause irreversible
opacity.
UV rays- Due to long term effect.
Disease of the eye- Inflammatory disease of eye
i.e. Koroditis.
Blunt trauma
Electric shock

16. DIAGNOSTIC TESTS
• History taking
• Plane Mirror Examination (to find out the
opacity)
• Slit lamp examination ( to magnify the opacity)
• Direct or indirect Opthalmoscopy (To find out
retinal disease)
• Perimetery ( to check vision)
• Tonometery ( To check intra ocular pressure)

17. MANAGEMENT
• Diagnosis of cataract based on decreased visual
acuity or other complaints of visual dysfunction.
•
• Medical management
• Medications administered pre and postoperatively
are:
• Dilating drops- Dilating drops are administered
every 10 minutes for four doses at least 1 hour
before surgery.

18. Antibiotic drugs- Antibiotic drugs may be
administered Prophylactically to prevent
postoperative infection and inflammation.
Intravenous sedation- Sedation may be used to
minimize anxiety and discomfort before surgery.
Surgical management
Lens replacement- There are three lens
replacement options:

19. Phacoemulsification- A portion of the anterior
capsule is removed, allowing extraction of the
lens nucleus and cortex while the posterior
capsule and zonular support are left intact.
Aphakic glasses. In aphakic glasses, objects are
magnified by 25%, making them appear closer
than they actually are.
Contact lenses. Contact lenses provide patients
with almost normal vision, but because contact
lenses need to be removed occasionally, the
patient also needs a pair of aphakic glasses.

20. Extra capsular cataract extraction (ECCE)-
ECCE removes the anterior lens and cortex,
leaving the posterior capsule intact.
Intra capsular cataract extraction- This
procedure removes the entire lens within the
intact capsule.

21. NUTRITIONAL MANAGEMENT

22. Nursing Management
Nursing assessment
The nurse should assess:
- Recent medication intake
- Vital sign
- Preoperative tests
- Visual acuity test results
- Patient’s medical history

23. Nursing diagnosis
• Disturbed visual sensory perception related to
altered sensory reception or status of sense organs
•Risk for trauma related to poor vision and reduces
hand-eye coordination.
•Anxiety related to threat of permanent loss of
vision/independence.
•Deficient knowledge regarding ways of coping
with altered abilities related to lack of exposure or
recall, misinterpretation, or cognitive limitations.

24. Nursing goal
Regaining of usual level of cognition.
Recognizing awareness of sensory needs.
Be free of injury.
Intervention
•Providing preoperative care. Use of anticoagulants
•is withheld to reduce the risk of retro bulbar
•haemorrhage.
•Providing postoperative care. Before discharge,
•the patient receives verbal and written instructions
•about how to protect the eye, medications, recognize
•signs of complications, and obtain emergency care.

25. HEALTH EDUCATION:
1. Teach patient and family proper hygiene and eye care
techniques to ensure that medications dressing, and/or
surgical wound are not contaminated during necessary
eye care.
2. Teach patient and family about signs and symptoms
of infection and how to report those to allow early
recognition and treatment of possible infection.
3. Instruct patient to comply with postoperative
restrictions on head positioning, to optimize to visual
outcomes and prevent increased IOP.

26. CONCLUSION
Cataract is a clouding of the lens in the eye
which leads to a decrease in vision. Cataract surgery
is the principal refractive surgical procedure
performed in older adults. Technological advances
have allowed for improved surgery through smaller
incisions, resulting in better outcomes. Improvements
in lens implants provide better visual outcomes than
were previously possible.

27. ANY QUESTIONS?