KEBUTAAN KATARAK

dr. ROFIK ROHMAN

ASEP GUNAWAN S.kep.Ners.
Penyebab kebutaan terbanyak di seluruh dunia  katarak, diikuti
oleh glaukoma. Sebesar 21% tidak dapat ditentukan penyebabnya
dan 4% adalah gangguan penglihatan sejak masa kanak-kanak.
JABAR 1,5 %
 Angka Kebutaan Katarak
• Jml pddk kab Tasikmalaya 2015 adalah
1.735.998
• Jml pddk buta di kab Tsm 1,5% x 1.735.998
sekitar 26.000
• Sekitar 50%-nya diakibatkan oleh Katarak jadi
sekitar 13.000 dalam setahun
• Sekitar 1000 dalam sebulan
• Dibagi 25 hari kerja  40 operasi dalam sehari
kerja
 Angka Kebutaan Katarak

• jumlah operasi katarak di kab Tasikmalaya per tahun

menurut target CSR adalah 1,7 x 2000  3.400 operasi
per tahun
• Sekitar 285 operasi per bulan
• Sekitar 12 operasi per hari kerja
 Angka Kebutaan Katarak
• Jml operasi katarak di SMC sekitar 2 mata per
hari kerja
• Sekitar 50 mata per bulan  600 per tahun
• 600 / 3400  17,5 %
• Masih jauh dari target Vision 2020
• Mengapa ?
• Riskesdas 2013 yaitu 51,6% karena tidak tahu,
11,6% karena tidak mampu dan 8,1% karena
takut operasi
Cataract
 Classification
• Etiological  Senile, Traumatic, Metabolic,
Toxic and Complicated
• Morphological  Capsular, Subcapsular,
Nuclear
• Stage of Maturity  Immature, Matuer,
Intumescen, Hypermature, Morgagnian
• Chronological  Cingenital, Infantile, Juvenile,
Presenile, Senile
 Stage of Maturity

1. Immature
2. Mature
3. Intumescent
4. Hypermature
5. Morgagnian
 Progression

1. Stage of Lamellar Separation

– Hydration
2. Stage of Incipient Cataract
– Early opacities appear
– Symptom e.g., glare, appear
3. Immature Cataract
– Diminution of vision
– Lens appears grayish white in color
– Iris shadow can be seen
 Progression
4. Intumescent Cataract
• The lens imbibes lot of fluid and becomes swollen
• Anterior chamber becomes shallow
• Angle of anterior chamber may close : Phacomorphic glaucoma

5. Mature Cataract
• Entire cortex becomes opaque
• Vision reduced to just perception
of light
• Iris shadow is not seen
• Lens appears pearly white
 Progression

6. Hypermature Cataract
This may take any of two form :
• Liquefactive or Morgagnian type : milky white
• Sclerotic Cataract with iridodenesis
• Vision improves to about finger counting at 1 meter
 Clinical Presentation
Symptoms
1. Glare
2. Image Blur
3. Diurnal Variation of Vision
4. Distortion (Metamorphopsia)
5. Diplopia/Polyopia
6. Altered Color Perception
7. Black Spots
8. Behavioral Changes
 Clinical Presentation
Signs
1. Visual Acuity : vision is diminished proportionate to
the degree of cataract (immature from 6/9 to
finger counting close to face; mature perception of
light or hand movements)
2. Leukocoria : white pupil
3. Iris shadow in immature cataract
4. Distant Direct Ophthalmoscopy (DDO) : red reflexes
depends on degree of cataract
 Differentiating Various Stages of Cataract

Features Immature Mature Hypermature

Vision 6/9 - FC HM - PL HM – FC
Anterior Normal (shadow Normal (shallow Normal to deep
Chamber in intumescent) in intumescent)
Color of Lens Grayish white Pearly white Milky white(with
browm crescent of
nucleus) or chalky
white
Iris shadow Seen Not seen Not seen

Distant Direct Black patches No red glow No red glow

Ophthalmoscopy againts red glow seen seen
HATURRRRRRR

NUHUN