Cataract

• The lens is a clear part of the eye that helps to focus light, or an image, on the
retina. The retina is the light-sensitive tissue at the back of the eye.
• The eye functions much like a camera. Light rays enter the eye, passing through
the cornea, the aqueous humor -- transparent fluid in the front of the eye -- and
then the pupil and into the lens. The lens bends the light rays to focus objects
onto the retina lining the back of the eye. From there, the image passes through
the retinal cells, into the optic nerve, and finally to the back of the brain which
process the images.
• The lens must be clear for the retina to receive a sharp image. If the lens is cloudy
from a cataract, the image you see will be blurred.
Cataract occur when there is a buildup of protein in the lens that makes
it cloudy. This prevents light from passing clearly through the lens,
causing some loss of vision. Since new lens cells form on the outside of
the lens, all the older cells are compacted into the center of the lens
resulting in the cataract.
 TYPES OF CATARACTS
• Age-related cataracts (Senile cataracts). As the name suggests, this
type of cataract develops as a result of aging.
• Congenital cataracts. Babies are sometimes born with cataracts as a
result of an infection, injury, or poor development before they were
born, or they may develop during childhood.
• Secondary cataracts. These develop as a result of other medical
conditions, like diabetes, or exposure to toxic substances, certain
drugs (such as corticosteroids or diuretics), ultraviolet light, or
radiation.
• Traumatic cataracts. These form after injury to the eye.
 EPIDEMIOLOGY
• Senile cataract is the main cause of visual impairment and blindness
in Indonesia and in the world
• In recent studies done in China, Canada,
Japan,Denmark,Argentina,and India,cataract was identified as the
leading cause of visual impairment and blindness, with statistics
ranging from 33.3% (Denmark) to as high as 82.6% (India).
 CAUSES
• Diabetes mellitus—Persons with diabetes are at higher risk for cataracts.
• Drugs—Certain medications have been found to be associated with the development of a
cataract. These include:
• Corticosteroids
• Chlorpromazine and other phenothiazine related medications
• Ultraviolet radiation —Studies have shown that there is an increased chance of cataract
formation with unprotected exposure to ultraviolet (UV) radiation.
• Smoking - An association between smoking and increased nuclear opacities has been reported.
• Alcohol - Several studies have shown increased cataract formation in patients with higher alcohol
consumption compared with people who have lower or no alcohol consumption.
• Nutritional deficiency —Although the results are inconclusive, studies have suggested an
association between cataract formation and low levels of antioxidants (e.g. vitamin C, vitamin E,
carotenoids). Further studies may show that antioxidants have a significant effect on decreasing
cataract development.
 SIGNS AND SYMPTOMS
• Decreased visual acuity - The most common complaint of patients with
senile cataract
• Glare - Can range from a decrease in contrast sensitivity in brightly lit
environments or disabling glare during the day to glare with oncoming
headlights at night
• Myopic shift - The progression of cataracts frequently increases the
diopteric power of the lens, resulting in a mild to moderate degree of
myopia or myopic shift
• Monocular diplopia - At times, the nuclear changes are concentrated in the
inner layers of the lens, resulting in a refractile area in the center of the
lens; this may lead to monocular diplopia that is not corrected with
spectacles, prisms, or contact lenses
 TREATMENT
• The treatment of cataracts is based on the level of visual impairment
they cause.
• If a cataract affects vision only minimally, or not at all, no treatment
may be needed.
• In some cases, a change in eyeglass prescription may provide
temporary improvement in visual acuity. Increasing the amount of
light used when reading may be beneficial. The use of anti-glare
coatings on clear lenses can help reduce glare for night driving.
• When a cataract progresses to the point that it affects a person's
ability to do normal everyday tasks, surgery may be needed.
 PREVENTION
• Wearing sunglasses outside during the day might reduce your
chances of developing cataracts or having problems with the retina.
Some sunglasses can filter out UV light, reducing exposure to harmful
UV radiation and might slow the progression of cataracts.
• For people who have diabetes, tight blood-sugar control can delay the
otherwise accelerated development of cataracts
 REFERENCES
• Ocampo VV. Senile Cataract. Available at
http://emedicine.medscape.com/article/1210914-overview. Accessed
: November 13, 2015
• National Eye Institute. Facts About Cataract. Available at
https://nei.nih.gov/health/cataract/cataract_facts. Accessed :
November 13, 2015