ncm104.communicable diseases
TRANSCRIPT
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injection n the skin of Sporozoite
travels in the bloodstream and live/mature in theliver
release of merozoites in the bloodstream
manifestations of Signs and Symptoms
invasion of RBCs
RBC's lyse and release new parasites
invasion of new RBC's by the newgen parasites
Take up by Anopheles mosquito
Malaria
Acute and chronic parasitic disease transmitted by the bite of infected mosquitoes and it is confined mainly to tropical and subtropical areas
EtiologyP. falciparum, P. vivax, P. malariae, P. ovale
Bite form Anopheles species mosquito Diagnostic Exams Medical Management Nursing ManagementIncubation period 12-30 days
Pathophysiology Clinical Manifestations
CBC_Low Hemoglobin,
low hematocrit
Malarial Smear_
presence of malarial
antigen
Rapid diagnostic
test(RDT)_ detect
malarial parasite antigen
in the blood
Anti-malarial drugs
Chloroquine
Quinine
Sulfadoxine for the
resistant P.
falciparum Primaquine for relapse
of P. vivax & ovale
Erythrocyte exchange
transfusion for rapid
production of high
levels of parasites in
the blood
Monitor VS
Monitor I and O,
Bilirubin and parasitic
levels
TSB during febrile
periods
Offer large amount of
fluids
Monitor for quinine
toxicity
Monitor for bleeding
Pathognomonic sign:
P-rofuse sweatingH-epatomegalyA-nemiaS-pleenomegalyE-levated temperature
Fever
Shaking chills
muscle pains
back pain
nausea
headache
Myalgia, with feeling of
well-being in between
Vomiting
Changes in sensorium
Orthostatic
hypotension
Health TeachingAdvise to avoid being bitten by mosquitoes, use long clothes, and avoid using
perfumes of colognes, and use repellants such as lotions, etc. especially during dusk
to dawn.
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Meningitis
Inflammation of the lining around the brain and spinal cord caused by a bacteria or virus.
Etiology
Neisseria meningitides
thru droplet transmission of pharyngeal secretions
penetrating head or spinal wound
direct invasion from otitis mediaDiagnostic Exams Medical Management Nursing Management
Incubation period 1 to 10 days
Pathophysiology Clinical Manifestations
Lumbar
Puncture/CSF Gram
staining-low glucose,
high protein, highWBC
CT/MRI-see shift in
skull contents
Cephalosphorins-
(ceftriaxone)
Ampicillin
Aminoglycosides Digitalis
Acetaminophen
Mannitol
anticonvulsants
monitor vital signs
monitor neurologic
status
maintain adequate
nutrition andelimination
follow strict aseptic
technique when
carrying out
procedure
isolation
Pathognomonic sign:
nuchal rigidity
neck, shoulder and
back stiffness
opisthotonus
+ kernigs sign
+brudzinskis sign
Headache
Fever w/ chills
Photophobia
petechial,
purpuric, or
ecchymotic
hemorrhages
alteration in LOC
Health Teaching eat foods rich in protein
teach patient the purpose of his isolation Provide support to the family and patient.
Entry of microorganism in the bloodstream
crossing the blood brain barrier
proliferation of microorganism in the CSF
release of cell wall fragments andpollysaccharides
inflammation
increase ICP
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Dengue Hemorrhagic Fever
an acute febrile disease caused by infection with one of the serotypes of dengue virus
Etiology Bite of mosquito (Aedes specie)Diagnostic Exams Medical Management Nursing Management
Incubation period 3-14 days commonly 7-10 days
Pathophysiology Clinical Manifestations
Tourniquet test-
fragile veins
Rumpel Leads test-
more than 20
petechiae in a square
inch
CBC-low platelet
count, elevated
hematocrit Guaiac stool exam-
presence of blood
Analgesics except
aspirin
IV fluids for
replacement
Oxygen therapy
Monitor vital signs
Apply cold ice pack to
patients nose bridge
and forehead during
epistaxis
Keep patient in a
mosquito free
environment
Position patient-trendelenburg;
Avoid puncturing the
patients skin
isolation
Pathognomonic Sign
S hock
H igh fever and
H emoptysis
A bdominal pain
M elena
E pistaxis
Bleeding gums
Purple blanched skinwith rash
convulsions
Anorexia
Vomiting
Myalgia
Health Teaching
Avoid too many hanging clothes outside the house
Change water in the vase everyday, dont leave clean water unsealed
Use insecticides
Use mosquito repellants
virus deposited in the skin
replication of virus at site of infection and lymphatictissue
viremia 4-5 days after onset of symptoms
macrophages are the initial site of infection
increase in vascular permeability, hypotension,hemoconcentration, thrombocytopenia, with increased
platelet agllutinability and moderate DIC
hypovolemic shock
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Chickenpox/Varicella
An acute and highly contagious disease caused by Varicella zoster, characterized by vesicular eruptions on the skin and mucous membrane with mild constitutional
symptoms.
Etiology Airborne and contact with infected personDiagnostic Exams Medical Management Nursing Management
Incubation period 10-21 days
Pathophysiology Clinical Manifestations
Complement Fixation
Test to determine
the V-Z Virus
Electron Microscopic
Exam of the vesicular
fluid
Zoverax
Oral antihistamine
Calamine lotion
Antipyretic
RespiratoryIsolationis a must until all
vesicles have crusted.
Prevent secondary
infection of the skin
lesion through hygienic
care of the patient.
Linens must be
disinfected under the
sunlight or through
boiling. Cut fingers nails short
and wash hands more
often.
Provide activities to
keep child occupied to
lessen pruritus
pre-eruptive
mild fever and malaise
Eruptive Stage
a. Rash starts from
the trunk, then spread
to other parts of the
body.
b. Initial lesions are
distinctivelyredpapules where
contents become milky
and a pus-likewithin 4
days.
Health Teaching tepid bathing or cool compresses may help to alleviate itching Advise stay away from work or school until fully recovered
entry of virus(inhalation)
viral replication in regional lymph nodes
production of immunoglobulins
spread of viral particles over the skin
appearance of vesiculo-papular rash
crusting(convalescence)
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Influenza
An acute viral infectious disease affecting the respiratory system caused by influenza virus A,B, and C.
EtiologyAirborne and contact with infected person and indirectly through
articles Diagnostic Exams Medical Management Nursing ManagementIncubation period 24-72 hours
Pathophysiology Clinical Manifestations
CBC-elevated WBC
PCR testing-presence
of influenza virus
Influenza specific
antibody
Antipyretics
Monitor VS
TSB
Encourage enough
fluid intake-replace
fluid loss
Promote bed rest
Encourage to deepbreathe
Give antipyretics
Fever
headache,
myalgia
lethargy
coryza
sore throat
cough
nausea
vomiting
diarrhea
Croup
Health Teaching Encourage proper body hygiene and regular hand washing
Advise family no to use same things as the patient
Advice not to use aspirin.
entyr of microorganism in the body
bacteria travels in the bloodstream
bacteria damages the epithelium of thetracheobronchial tree
activation of immune processes
fever and other signs and symptoms
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Leptospirosis
Zoonotic infectious bacterial disease carried by animals, both domestic and wild, whose urine contaminates water or food which is ingested or inoculated through the
skin.
EtiologyLeptospira interrogans
Urine of animals (esp. rats) contaminated with this
bacteria Diagnostic Exams Medical Management Nursing ManagementIncubation period 24-72 hours
Pathophysiology Clinical Manifestations
Serologic Test:
Microscopic
Agglutination test
(MAT)
Isolation of
Leptospires:
= 1 7 days - from blood= 4 10 days - from CSF
(during acute stage
= after 10th day - from
urine
Penicillin GNa Tetracycline
erythromycin
Peritoneal Dialysis
Administration of fluidand electrolyte and
blood as indicated.
Isolate the patient,
urine must be
properly disposed of.
Keep patient under
close surveillance.
For home care, dirty
places, pools, andstagnant water must
be cleaned.
Eradicate rats androdents.
Fever lasting 4 7
days
Chills, headache,
anorexia, abdominalpain
With or without
jaundice
Convulsions
Health Teaching Encourage proper body hygiene Tell how the disease is acquired and the possible prevention methods.
entry of bacteria through broken skin or mucousmembrane
damage in the blood, kidney and liverparenchyma
activation of antibodies and immune cascade
lysis of the infected cell
malfunction of the affected organs and blood
blood stream invasion of leptospire and retentionto other tissues
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Pertussis/Whooping cough
infectious disease characterized by repeated attacks of spasmodic coughing which consists of a series of explosive expirations, typically ending in a long-drawn forced
inspiration which produces a crowing sound, the whoop & usually followed by vomiting
Etiology Bordetella pertussis Contact with respiratory droplets Diagnostic Exams Medical Management Nursing Management
Incubation period 7-14 days
Pathophysiology Clinical Manifestations
PCR test-Positive for
B.pertussis RNA
Nasopharyngeal swabs
Sputum culture
CBC (Leukocytosis)
Fluid & electrolyte
replacement
adequate nutrition
oxygen therapy
Antibiotics
(erythromycin &icillin)
DPT vaccine
Isolation and asepsis
should be carried out.
Should not leave the
patient alone.
Suctioning equipment
should be ready at all
times for emergency
use to avoid airway
obstruction.
Sunshine & fresh air
are important. Provide warm baths,
keep the bed dry &
free from soiled
linens.
Intake & output
should be closely
monitored.
Pathognomonic Sign:
Whooping cough
Coryza
Sneezing
Lacrimation
Cough
low-grade fever
Health Teaching Advise to submit to immunization
entry of bacteria through airways
attachment to bronchial epithelium
proliferation of bacteria
inflammation
mucopurulent discharges which can lead tosanguinous discharges
compromised airways
respiratory failure
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Measles/Rubeolla/Morbilli
An acute, contagious and enanthematous disease caused by Morbilivirusthat usually affects children which are susceptible to URTI.
EtiologyDroplet spread of infected person or indirectly through soiled
articles Diagnostic Exams Medical Management Nursing Management
Incubation period 10-14 days
Pathophysiology Clinical Manifestations
CBC
Anti-measles IGM
Measles RNA
Nose and throatswab
Anti-viral drugs
(Isoprenosine)
Antibiotics if with
complicationSupportive therapy
Monitor VS
Isolate the
patient(strict
isolation)
Provide Enough fluids
TSB for fever
Oral hygiene and skin
care
Pathognomonic Sign:Kopliks spot3 Cs: Conjunctivitis,
Coryza and Cough
Fever
Red blotchy rashappears on the 3rd
day to 7th day in
cephalocaudal
direction
Hot Skin
Sore throat
Health Teaching Advise to submit to immunization
entry of virus through the upper respiratory
multiplication and spread of virus to lymphatic tissue
establishment of infection in the skin and tissues of resp.tract.
koplik's spots
development of rashes
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Leprosy/Hansens Disease
a slowly progressive bacterial infection involving the cooler body tissues, skin, superficial nerves, nose, pharynx, larynx, eyes and testicles
EtiologyMycobacterium leprae
Through droplet transmission and thru break in the skin and
mucous membraneDiagnostic Exams Medical Management Nursing Management
Incubation period 9 months to 20 yearsPathophysiology Clinical Manifestations
Slit Skin Smear -
determines the
presence of M. leprae;
Lepromin Test
determines
susceptibility toleprosy (+)-
tuberculoid;(-)-
lepromatous.
Mitsuda Reaction
PAUCIBACILLARY
Rifampicin
Dapsone
MULTIBACILLIARYRifampicin
Dapsone
Lamprene
Monitor patients
vital
Maintain a clean
environment to avoid
secondary infection
Avoid contact with
children/infants Avoid prolonged skin
to skin contact with
the patient
Maintain balance
nutrition, sleep and
rest
skin color change- red or
white
sensation loss
Loss of sweating and hair
growth
Thickened and painful
nerves
Muscle weakness or
paralysis
Pin and redness of the
eyes Nasal obstruction/
bleeding
Ulcers that do not heal
Late Signs:
Madarosis
Loss of eyebrows
lagophthalmos
Clawing of fingers and toes
Contractures
Chronic ulcers
Sinking of the nosebridge
gynecomastia
Health Teaching Advice vaccination-BCG Advice to maintain a good hygiene
M. lerprae enters the system upon droplet orprolonged contact
Agent spreads out in the system and navigates thebody through thermoreceptors into cell membrane of
the bacteria
M. leprae proliferates to cooler areas of the bodyavoiding the warm interior areas in the viscera
M. leprae accumulates and duplicates to theperipheral nerves, mucosa, epidermis, surface of the
nose and mouth
Bacteria attacks the skin and produces skin lesions,light-colored patches of skin that often develop
anesthesia, or loss of sensation
Trauma/injury aggravates these skin lesions and thebody fails to develop to respond and repair to the
injury
These lesions lead to severe disfigurement of thepatient
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Tetanus/ Lock Jaw
A highly fatal disease caused by anaerobic bacteria characterized by muscle spasm and rigidity.
EtiologyClostridium tetani
Indirect contact ,soil, street dust, animal and human
feces, punctured woundDiagnostic Exams Medical Management Nursing Management
Incubation period 3 days to 1 month
Pathophysiology Clinical Manifestations
No Specific
diagnostic exam,only a history of
punctured wound
ATS
Tetanus Toxoid Diazepam
Pen G
Maintain an
adequate airway
Adequate fluid
and electrolytes
No restraints Proved quiet semi
dark environment
Skin test before
administering
serums
Pathognomonic Sign:Risus Sardonicus /
Sardonic Smile
Lock jaw/ Trismus
Opisthotonus
Laryngeal/ pharyngeal
spasm Generalized muscular
rigidity
Health Teaching Advise patient to always clean wounds with soap and water.
entry of bacteria
production of toxins
circulation of the toxins through the body
entry of the toxins in the spinal cord
uptake by neuromuscular junction of thetoxin
after 3 days to 1 month- muscle spasm
signs and symptoms
death
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Diphtheria
characterized by formation of pseudomembranre commonly in the faucial area and tonsils by the exotoxin produced by Corynebacterium diphtheriae
Etiology Corynebacterium diphtheriathru dropletDiagnostic Exams Medical Management Nursing Management
Incubation period 2-5 days
Pathophysiology Clinical Manifestations
schicks test
determine
susceptibility or
immunity
nose and throat swab
maloneys test
determinehypersensitivity to
diphtheria toxoid
Diphtheria
Antitoxin
Penicillin or
Erythromycin
Tracheostomy for
laryngeal
obstruction
Assess the
patients ability to
swallow before
giving medications
Provide ice packs
to relieve pain
Isolate patient
with respiratory
precautions
Pathognomonic Sign:
Pseudomembrane
Bull neck Dysphagia
Dyspnea
Health Teaching
Advise to take adequate fluids Encourage to maintain oral hygiene
Encourage to deep breath and cough effectively
absorption of toxins in the mucous membrane
destruction of epithelium
superficial inflammation
formation of pseudomembrane( necroticepithelium, leukocytes, fibrin)
bacilli continue to produce toxins
parenchymatous degeneration, fatty inflitration,necrosis of heart muscles, liver, kidney, adrenals
nerve damageparalysis of soft palate, eye musclesand extremities
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Rabies/Lyssa/Hydrophobia
severe viral infection of the CNS that is communicated to human in the saliva of infected animals or human caused by rabies virus
Etiology Rhabdovirus of the genus lyssavirusDiagnostic Exams Medical Management Nursing Management
Incubation period 2-8 weeks
Pathophysiology
Clinical Manifestations
1. negri bodies in the
brain
2. history of exposure
3. flourescent RABIES
ANTIBODY (FRA)
TECHIQUE highly
preferred diagnostic
exam wherein the
fluorescent rabies
antibody is allowed to
react with its specificantigens in culture or
smear and the result is
in precipitate form -
positive
Immunizations
Anti-rabies vaccine
Human diploid cell vaccine
(hdcv)Duck embryo vaccine
RABUMANHYPER RAB
IMOGRAM Symptomatic
treatment/no cure
Monitor patient
for signs and
symptoms
Administer the
prescribed
immunization
Pathognomonic Sign:
hydrophobia
paralysis
fever
PRODROMAL
Headache
Sore throat
Unusual salivation
Diaphoresis
Low grade fever
EXCITEMENT
Increased anxiety
Hydrophobia Pharyngospasm
Photophobia
Aerophobia due to
laryngospasm
Maniacal behavior
PARALYTIC
Die of paralysis
Respiratory or
cardiac arrest
Health Teaching Tell patient to wash bite wounds with soap and water and immediately go to a
health center
Advise patient to take care of their animals
entry of virus in the body
attachment of viral glycoprotein in the nicotinicacetylcholine receptor of muscle
initial replication in the myocytes
virus spreads until it reach the spinal cord and CNS
virus spreads in the skin, intestine, salivaryglands(shed in saliva)
deterioration of CNS
death
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Tuberculosis
An infectious disease that primarily affects the lung parenchyma and can be transmitted to other parts of the body.
Etiology Mycobacterium tuberculosisDiagnostic Exams Medical Management Nursing Management
Incubation period 4 6 weeks
Pathophysiology Clinical Manifestations
Sputum examination or
the Acid-fast bacilli
(AFB) / sputum
microscopy
Chest X-ray
Tuberculin Test
purpose is to
determine the history
of exposure to
tuberculosis
Rifampicin
Isoniazid
Pyrazinamide
Ethambutol
Streptomycin
Isolate patient
Monitor vital signs
Maintain a patient
airway
Collaborate with
dietician for diet
Pathognomonic Sign:
Blood-tinged sputum
Fever and chills
Night sweats
Dyspnea
Non-productive
/productive cough with
purulent sputum Loss of appetite
Weight loss
Health Teaching Encourage patient to adhere to treatment regimen Promote activities and encourage rest between deeds
bacteria is inhaled by the host
travels in the airways and in the blood stream
damages the lung parenchyma
macrophages and lymphocytes attack the bacteria
production of mucopurulent and blood tingedsputum
other bacteria proliferates in the lymphatic tractand in the blood stream which damages other
organ and systems
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German Measles/Rubella
An acute contagious virus disease that is in milder form compared to measles but is damaging to the fetus when occurring early in pregnancy and is caused by togavirus.
Etiology RUBELLA VIRUS thru direct or indirect contactDiagnostic Exams Medical Management Nursing Management
Incubation period 3 days
Pathophysiology Clinical Manifestations
Rubella Titer-
indicates
susceptibility to
rubella
MMR
Analgesic and
antipyretics
TSB for fever
Oral hygiene
Give enough fluids
Provide skin care
Promote bed rest
Pathognomonic Sign:
Forscheimer spots
Maculopapular rashes
Headache
Low-grade fever
Sore throat
lymphadenopathy
Health Teaching Advise the mother not to get pregnant three months after receiving MMR Tell the patient that the disease is self-limiting
entery of bacteria directly, indirectly ortransplacentally
travels in the blood stream
initiation of inflammation
nasal congestion
swelling of the glands and fever
travels in the skin and produces rash
in the placenta, it prodeuces congenital anomalies
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Hepatitis B
A fatal hepatitis that tends to persist in the blood serum and is transmitted by contact in infected blood and body fluids.
Etiology Hepatitis B virus thru blood, body fluids, placentaDiagnostic Exams Medical Management Nursing Management
Incubation period 45-100 days
Pathophysiology Clinical Manifestations
Hepatitis B surface
agglutination
(HBSAg) test
Liver enzymes,
such as serum
aspartateaminotransferase
and alanine
aminotransferase
levels, are elevated
Hepatits
immunoglobulin
lamivudine [Epvir] adefovir [Hepsera
Promote a diet
rich in protein,
vitamins and
minerals
Monitor vital signs
Promote bed rest
Assess patient for
bleeding
tendencies
Provide pain reliefmeasures such as
heat, back rubs,
positioning,
relaxation
techniques, and
age-appropriate
diversion
clay-colored stools
jaundice
steatorrhea
right-sided
abdominal pain yellowish sclera
anorexia
nausea and vomiting
Health Teaching encourage patient to avoid greasy foods discuss ways to avoid acquiring the disease
entry of virus in thebody
virus travels in thebloodstream
release of viral DNA inthe hepatocytes
infection
direct cell lysis
appearance of signsand symptoms
activation of theantibodies
antibodies acts on theinfected cells of the
liver
lysis of the infectedcell
appearance of signsand symptoms
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Filariasis
It is a parasitic disease caused by an African eye worm, a microscopic thread-like worm. The adult worm can only live in human lymphatic system and can cause extensive
disability and gross disfigurement.
EtiologyWuchereria bancrofti
through the bite of Aedes mosquito Diagnostic Exams Medical Management Nursing ManagementIncubation period 8 to 16 months
Pathophysiology Clinical Manifestations
Circulating filarial
antigen- finger
prick blood droplet,
taken any time of
the day and gives
result in a fewminutes
Nocturnal blood
examination-
performed at night
time pass 8:00 pm
diethycarbamazine
citrate (hetrazan)
surgical treatment for
hydrocele
monitor vital signs
During chronic
stages, provide
safe environment
to reduce
incidence of injury
Monitor intake and
output and weigh
daily forevaluation
Reduce noxious
environment to
relieve pain and
discomfort
Presence of filariae
in the blood
Lymphadenitis
Lymphangitis Affectation of male
genitalia
Hydrocele
Lymphedema
Elephantiasis
Health Teaching
Reinforce compliance to treatment regimen
Stress importance of good handwashing technique and proper body hygiene Stress importance of mobility during chronicity
Use of mosquito repellents; Anytime fumigation
Wear a long sleeves, pants and socks
entry of worms in the mosquito's body after biting aninfected person
mosquito bites an uninfecetd person
worms live for 7 years in the lymphatic system andreleases microfilaria in the bloodstream
the person can transmit again filariae via mosquitobites
the larvae matures in the lymph nodes
the person must have several bites
damage in the kidney and lymph vessels
swelling in the arms, genitals, legs
enlargement of tissues due to blood vesselobstruction by the worms
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Bacterial Pneumonia
Disease of the lungs that is characterized by inflammation and consolidation of lung tissue followed by resolution is accompanied by fever, chills, cough, and difficulty in
breathing and is mainly caused by infection.
EtiologyPneumococcus, streptococcus
pneumoniae, staphylococcus aureus, Klebsiella pneumonia
Droplet transmissionDiagnostic Exams Medical Management Nursing Management
Incubation period 2-3 daysPathophysiology Clinical Manifestations
Chest x-ray
Sputum culture for
confirmation
Signs and
symptoms Dull percussion of
lungs
Oxygen inhalation
Antibiotics
Mucolytics
Bronchodilators suctioning
Monitor vital signs
Monitor O and I
Promote bed rest
Increase OFI
TSB for fever
Promote optimal
positioning
CPT
Pathognomonic Sign:
Rusty sputum
Chest pain
Intercostal retraction
tachypnea Nasal congestion
Cough
orthopnea
Health Teaching Teach patient breathing and coughing exercise
Tell the patient necessary precautions to avoid transmission
Encourage to adhere to treatment regimen
entry of microorganism in the body
travel of microorganism in the bloodstream
infection of the alveoli
production of exudates and cell-bacteria debris duecellular immunity which fill the alveolar spaces
scattering of infection in the lungs
stiffening of the lungs due to scarring which can leadto hypoxemia
hypoxemia and other signs and symptoms
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Cataracts are the leading cause of preventable blindness among adults in the United States. The incidence of cataracts in the United States is 1.2 to 6.0 cases per 10,000 people. A cataract is defined asopacity of the normally transparent lens that distorts the image projected on the retina. The lens opacity reduces visual acuity. As the eye ages, the lens loses water and increases in size and density, causing
compression of lens fibers. A cataract then forms as oxygen uptake is reduced, water content decreases, calcium content increases, and soluble protein becomes insoluble. Over time, compression of lens fiberscauses a painless, progressive loss of transparency that is often bilateral. The rate of cataract formation in each eye is seldom identical. Without surgery, a cataract can lead to blindness.