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Chapter 10. Diseases of the lens
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Defination of cataract
Transparent lens becomes opaque,
called cataract
VA<0.7
Types of cataract
age-related ,congenital ,
traumatic, diabetic,etc
Age-related cataract
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Etilogy: risk factors
heredity
ultraviolet ray
systemic disorders(hypertension,
diabetes, arteriosclerosis)
nourishment condition
Clinical manifestation
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Bilateral, onset may be early or late,
Progressive blurred vision
Fixed black spot
Monoular diplopia
polyplopia
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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,
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
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Nuclear cataract
at beginning, lens nucleus
appears grey-yelloeish, its
color becomes deeper with
going near to the center.
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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
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Surgery
1.
2.
3.
4.
5.
6.
Glasses
Contact lens
ECCE,
ICCE,
Phaco,
IOL implantation
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Drug therpy
Placibo, antioxidant
Vit B2
Vit C
Vit E
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Question:
1. How to correct aphakia after cataract
surgery?
2. How many types of age-related
cataract?
Congenital cataract
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Etiolgy
hereity
viral infection
drug abuse during 1st trimester
metabolic disoders during
pregnancy
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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
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Diagnosis & Treatment
Easy to diagnose
Surgery: aspiration
correction after surgery:
1.Glasses
2.Contact lens
3.IOL implantation
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Traumatic cataract
Etiology
1. Contusion
2. Penetrating
3. Explosive
4. Electric
Diabetic cataract
 Complicated cataract
 Toxic cataract
 After-cataract
 Dislocation or sublislocation
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