Management of cataract

1. Management of Cataract
Md.Asaduzzaman
Associate Optometrist

2. Normal Eye Vs Cataract
Eye

3. NON SURGICAL
MANAGEMENT (Medical)

4. Treatment of the causes of cataract
Adequate Control of Diabetic mellitus.
Removal of cataractogenic drugs such
as corticosteroid,strong miotics.
Early and adequate treatment of ocular
diseases such as Uveitis.

5. Measures to improve cataract in
the presence of immature
cataract
1.No treatment can restore the
cataractous lens to its original
transparent state.
2.Frequent and accurate refraction to
maintain vision at the best possible level.

6. SURGICAL MANAGEMENT

7. Indications for cataract surgery
There are three indications which are as follow
1.Visual Improvement (Optical Indication):This is
the most important indication for cataract
surgery.When cataract develops to a degree
which interfere with daily essential activities
cataract surgery is indicated.

8. Cont.
2.Medical Indication:This is the
condition in which cataract itself
causing complications such as
phacolytic glaucoma,phacomorphic
glaucoma and lens induced uveitis.

9. Cont.
3. Cosmetic indication: When cataract
surgery is done to obtine black pupil only.

10. Preoperative Evaluation
Before cataract surgery a patient needs
1.General medical examinations.
2.Local Ophthalmic examinations.
3.Laboratory investigations.
4.Biometry

11. General medical examinations
Examination of cardio vascular system,
respiratory system, nervous system is
done to rule out any contra-indication for
cataract surgery under local anesthesia.

12. Local ophthalmic examinations
VA recording
Colour vision
Pupillary reaction
IOP
SPT
Ocular adnexa
Anterior Segment
Posterior Segmen

13. Laboratory Examinations
RBS (Random blood suger)
ECG(Electro-cardio-gram)
Conjuntival swab for culcture and
sensitivity(C/S)

14. Biometry
The process by which Intra-ocular- lens (IOL)
power is determine is called biometry.
There is a formula known as SRK established by
Sanders, Retzlaff and Kraft to determine the
power of an intraocular lens implant
Formula is as follow
 P = A − 2.5L − 0.9K

15. Types of Cataract surgery
Two main types of surgical procedures are in
common.
The first procedure is phacoemulsification
(phaco) and the second involves two different
types of extracapsular cataract extraction(ECCE)
and another is Intaracapsular cataract
extraction(ICCE)

16. Different technique of ECCE
SICS with PCIOL
PHACO with PCIOL

17. Technique of ICCE
ICCE with AC IOL
Not routinely done

18. Any Question