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Introduction
A cataract is a lens opacity or cloudiness. It
can be either localized or generalized. The
most common cataract is related to aging,
although cataracts can have a variety of other
causes. According to World Health
Organizations (WHO), cataract is the leading
cause of blindness in the world.
Types
1. Nuclear Cataract
-occurs at the back of the lens. People with diabetes or those
taking high doses of steroid medications have a greater risk
of developing a subcapsular cataract.
2. Cortical Cataract
-forms deep in the central zone (nucleus) of the lens. Nuclear
cataracts usually are associated with aging.
3. Posterior Subcapsular Cataract
-is characterized by white, wedge-like opacities that start in the
periphery of the lens and work their way to the center in a
spoke-like fashion. This type of cataract occurs in the lens
cortex, which is the part of the lens that surrounds the central
nucleus.
PATHOPHYSIOLOGY
Changes in the lens proteins affect how the lens
STAGES
Early Stage - the cataract is not completely
cloudy.
Second Stage- the cataract is completely
opaque, and vision is significantly reduced
Third Stage- cataract lenses absorbed water
and increase in size, resulting in IOP.
Last Stage- the proteins in the lens break
down and leak out through the lens capsule.
Risk factors
Age
Cigarette smoking
Long term use of corticosteroids
Sunlight and ionizing radiation
Diabetes
Obesity
Eye injuries
Clinical Manifestations
Painless, blurry vision
Reduced contrast sensitivity, sensitivity to
Diagnostic Test
Snellen Visual Acuity Test
Opthalmoscopy
Slit-lamp biomicroscopic examination
Medical/Surgical Management
Phacoemulsification- a portion of the
Nursing Intervention
Preoperative Care
Dilating drops are adm every 10 minutes for at least 1
hr before surgery
Additional dilating drops may adm in the operating
room
Antibiotic, corticosteroid, and anti-inflammatory drops
may be adm prophylactically to prevent postoperative
infection and inflammation
Postoperative Care
Adm medications, recognize signs of complications,
and obtain emergency care
Explain that there should be minimal discomfort after
surgery and instruct patient to take minimal analgesic
agent