ppt cataract
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A cataract is a clouding that develops inthe crystalline lens of the eye or in itsenvelope (lens capsule), varying in degreefrom slight to complete opacity and
obstructing the passage of light. Early in thedevelopment of age-related cataract, thepower of the lens may be increased, causingnear-sightedness (myopia), and the gradualyellowing and opacification of the lens mayreduce the perception of blue colors.
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Mild clouding of the lens often occurs afterage 60, but it may not cause any visionproblems.
By age 75, most people have cataracts thataffect their vision.
Visual problems may include the followingchanges:
Photophobia Cloudy, fuzzy, foggy, or filmy vision
Difficulty seeing at night or in dim light
http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003029/http://www.ncbi.nlm.nih.gov/pubmedhealth/n/pmh_adam/A003029/ -
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Double vision (monocular diplopia) Loss of color intensity
Problems seeing shapes against a
background or the difference between shadesof colors
Seeing halos around lights
Red reflex seen with direct opthalmoscope is
distorted or absent
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Increasing age Drinking excessive amounts ofalcohol
Excessive exposure to ultravioletlight
People who live in high altitudes or
who works in bright sunlight
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From systemic disorders (diabetes, tetany,myotonic dystrophy, neurodermatitis,galactosemia, Lowe syndrome, Wernerssyndrome and Downs syndrome)
From intraocular disorders (iridocyclitis,retinitis, retinal detachment andonchocerciasis)
From infections (german measles, mumps,hepatitis, poliomyelitis, chickenpox,infectious mononucleosis)
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Blunt trauma Lacerations
Foreign bodies
Exposure to ionizing radiation, such as that
used in X-rays and cancer radiation therapy Family history of cataracts
High blood pressure
Obesity
Previous eye surgery Prolonged use of corticosteroid medications
Smoking
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History and PE Documentation of visual acuity
Ask client to describe visual disturbances
Assist client to gain or maintain as muchindependence as possible
Evaluate clients lifestyle, abilities, and homeenvironment
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Postop Care: The eye is covered with a dressing and eye shield
to protect it from injury
The patient is allowed out of bed the day
following surgery Daily change of dressing. After 7 to 10 days, all
dressings are usually removed
During the first month, protect the eye with a
shield at night Administer eye drops as ordered
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There is no known treatment other thansurgery that prevents or reduces cataractformation. But some research presented thategg yolks may improve vision. Preoperative
eyedrops may include a dilating agent suchas tropicamide (Mydriacyl) to facilitatesurgery. A cycloplegic cyclopentolate(Cyclogyl) may be administered to paralyzeciliary muscles.
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. Removal of cataractwithin its capsule. (ICCE)
. An opening is madein the capsule and the lens is lifted withoutdisturbing the membrane. An aphakic personis very farsighted (hyperopic) (ECCE)
, the cataract is lifted from the
eye by a small probe that has been cooled toa temperature below zero and adheres to thewet surface of the cataract.
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. Done preceeding cataractextraction to create an opening for the flowof the aqueous humor which may becomeblocked postop when the vitreous humor
moves forward. This is to prevent secondaryglaucoma.
A method of cataract removalwhich breaks up the lens and flushes it out intiny pieces.
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External eye examination reveals the following: Conjunctiva thins and becomes yellowish
White ring around iris (arcus senilis) does notaffect vision
Dry eyes due to decreased tear production Drooping eyelids (senile ptosis)
Entropion and ectropion common in the olderadult
Clouding of lens (cataracts) Yellowish nodules on bulbar conjunctiva
(pinguecula) common
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Visual examination reveals the following: Presbyopia (decreased near vision due to
decreased elasticity of lens) common inclients older than 45 years
Slowed pupillary response and slowedaccommodation
Poorer night vision and decreased tolerance
to glare
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Visual field examination reveals the following:
Decreased peripheral vision
Difficulty differentiating blues from greens
Funduscopic examination reveals thefollowing :
Pale narrowed arterioles
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The lens is made of mostly water and protein.The protein is arranged in a specific way thatkeeps the lens clear and allows light to passthrough it to focus a clear image onto the retinal
surface. As we age, some of the protein mayclump together and start to cloud a small area ofthe lens. This is our understanding of the causeof an age-related cataract. Over time, the
cataract may become more dense or cloud moreof the lens, making it more difficult to seethrough. A cataract is not a growth or tumor.