Mr. Jaydip J. Ninama is a lecturer in the department of medical surgical nursing. The document discusses the anatomy and physiology of the lens, causes and types of cataracts, signs and symptoms, diagnosis, and treatment. The main types of cataracts discussed are nuclear, cortical, subcapsular, and age-related cataracts. Treatment involves removing the cloudy lens surgically, usually through phacoemulsification. Post-operative care and potential complications are also outlined.
most common ophthalmic disorder seen in all over world. in India 2015 incidence of cataract patient was 62.6 % (9 million). so the awareness and the management is very important for this disease condition. i hope this presentation is very helpful to all the student and people to understanding the cataract refractive ophthalmic disease
most common ophthalmic disorder seen in all over world. in India 2015 incidence of cataract patient was 62.6 % (9 million). so the awareness and the management is very important for this disease condition. i hope this presentation is very helpful to all the student and people to understanding the cataract refractive ophthalmic disease
A cataract is a clouding or opacity that
develops in the crystalline lens of the eye or in its envelope, varying in degree from slight opacity to obstructing the passage of light.
Progressive, painless clouding of the natural, internal lens of the eye.
Gross Anatomy & Physiology of Eye
Introduction to cataract
Epidemiology of cataract
The etiological factors
Pathophysiology
Clinical manifestations
Types
Diagnostic measures
Surgical measures
Pre and post operative nursing management
Complications after surgery.
Summary
This is a topic of sensory organ and this is detailed topic and can be refered by all nursing students bsc, msc and gnm which give you overall idea and things related to cataractwhich include definition, anat and physio, risk factor, pathophysiology, clinical menifestation, diagnostic evaluation, and management
Nearsightedness (myopia) is a common vision condition in which near objects appear clear, but objects farther away look blurry. It occurs when the shape of the eye — or the shape of certain parts of the eye — causes light rays to bend (refract) inaccurately. Light rays that should be focused on nerve tissues at the back of the eye (retina) are focused in front of the retina.
Nearsightedness usually develops during childhood and adolescence, and it usually becomes more stable between the ages of 20 and 40. Myopia tends to run in families.
A basic eye exam can confirm nearsightedness. You can compensate for the blurry vision with eyeglasses, contact lenses or refractive surgery.
A cataract is a clouding or opacity that
develops in the crystalline lens of the eye or in its envelope, varying in degree from slight opacity to obstructing the passage of light.
Progressive, painless clouding of the natural, internal lens of the eye.
Gross Anatomy & Physiology of Eye
Introduction to cataract
Epidemiology of cataract
The etiological factors
Pathophysiology
Clinical manifestations
Types
Diagnostic measures
Surgical measures
Pre and post operative nursing management
Complications after surgery.
Summary
This is a topic of sensory organ and this is detailed topic and can be refered by all nursing students bsc, msc and gnm which give you overall idea and things related to cataractwhich include definition, anat and physio, risk factor, pathophysiology, clinical menifestation, diagnostic evaluation, and management
Nearsightedness (myopia) is a common vision condition in which near objects appear clear, but objects farther away look blurry. It occurs when the shape of the eye — or the shape of certain parts of the eye — causes light rays to bend (refract) inaccurately. Light rays that should be focused on nerve tissues at the back of the eye (retina) are focused in front of the retina.
Nearsightedness usually develops during childhood and adolescence, and it usually becomes more stable between the ages of 20 and 40. Myopia tends to run in families.
A basic eye exam can confirm nearsightedness. You can compensate for the blurry vision with eyeglasses, contact lenses or refractive surgery.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
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Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
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Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
CDSCO and Phamacovigilance {Regulatory body in India}NEHA GUPTA
The Central Drugs Standard Control Organization (CDSCO) is India's national regulatory body for pharmaceuticals and medical devices. Operating under the Directorate General of Health Services, Ministry of Health & Family Welfare, Government of India, the CDSCO is responsible for approving new drugs, conducting clinical trials, setting standards for drugs, controlling the quality of imported drugs, and coordinating the activities of State Drug Control Organizations by providing expert advice.
Pharmacovigilance, on the other hand, is the science and activities related to the detection, assessment, understanding, and prevention of adverse effects or any other drug-related problems. The primary aim of pharmacovigilance is to ensure the safety and efficacy of medicines, thereby protecting public health.
In India, pharmacovigilance activities are monitored by the Pharmacovigilance Programme of India (PvPI), which works closely with CDSCO to collect, analyze, and act upon data regarding adverse drug reactions (ADRs). Together, they play a critical role in ensuring that the benefits of drugs outweigh their risks, maintaining high standards of patient safety, and promoting the rational use of medicines.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
2. The lens
It’s crystalline.
Histology:
1. Capsule
2. Subcapsular epithelium (simple cuboidal).
• Synthesize protein for lens fiber
• Maintains a cation pump to keep the lens clear
1. Lens fibers
Cross section:
1. Capsule
2. Cortex
3. nucleus
3. Ciliary muscle
•Function:
• Constricts ciliary body
• Relaxes tension on lens
• Lens become spherical,
which increase the
refractive power
Ciliary process
•Attaches to the lenses by
suspensory ligament (zonular
fibers)
•Secrete the Aqueous humor
into the post. chamber
6. Epidemiology
1. Cataracts remain the
leading cause of blindness.
2. Age-related cataract is
responsible for 48% of
world blindness, which
represents about 18
million people
3. Cataracts are also an
important cause of low
vision in both developed
and developing countries.
7. Causes of cataract
• Old age (commonest)
• Ocular & systemic diseases
– DM
– Uveitis
– Previous ocular surgery
• Systemic medication
– Steroids
– Phenothiazines
• Trauma & intraocular foreign
bodies
• Ionizing radiation
– X-ray
– UV
• Congenital
– Part of a syndrome
– Abnormal galactose
metabolism
– Hypoglycemia
• Inherited abnormality
– Myotonic dystrophy
– Marfan’s syndrom
– Rubella
– High myopia
7
8. Any physical or chemical cause
↓
Disturbs the intracellular and extracellular equilbrium of water and
electrolytes
↓
Deranges the colloid system in lens fibres
↓
Aberrant fibres are formed from germinal epithelium of lens
↓
Epithelial cell necrosis
↓
Focal opacification of lens epithelium
(glaucomflecken)
↓
Opacification of lens
PATHOMECHANISM
9. Opacification of lens takeplace by 3 biochemical changes.
1. Hydration 2.Denaturation of 3.Slow
lens protein sclerosis
Abnormalities of lens proteins
&
Disorganisation of lens fibres
Loss of transparency of lens
Cataract
10. Cataract
Divided to :
• Acquired cataract
Age - related cataract(Senile Cataract)
Presenile cataract
Traumatic cataract
Drug induced cataract
Secondary cataract
• Congenital Cataract
Systemic association
Non-systemic association
11. Age -related cataract
It is the Most commonly occurred.
Classified according to:
Morphological Classification
• Nuclear
• Cortical
• Subcapsular
• Christmas tree – uncommon
Maturity classification
• Immature Cataract
• Mature Cataract
• Hypermature Cataract
12. Nuclear cataract
• Most common type
• Age-related
• Occur in the center of the lens.
• In its early stages, as the lens changes the
way it focuses light, patient may become
more nearsighted or even experience a
temporary improvement in reading vision.
Some people actually stop needing their
glasses.
• Unfortunately, this so-called 2nd
sight
disappears as the lens gradually turns more
densely yellow & further clouds vision.
• As the cataract progresses, the lens may
even turn brown. Advanced discoloration
can lead to difficulty distinguishing between
shades of blue & purple.
13. Cortical cataract
• Occur on the outer edge of the lens (cortex).
• Begins as whitish, wedge-shaped opacities or streaks.
• It’s slowly progresses, the streaks extend to the center and
interfere with light passing through the center of the lens.
• Problems with glare are common with this type of cataract.
14.
15. Subcapsular cataract
• Occur just under the capsule of the lens.
• Starts as a small, opaque area
• It usually forms near the back of the lens, right in the path of
light on its way to the retina.
• It’s interferes with reading vision
• Reduces vision in bright light
• Causes glare or halos around lights at night.
16. Posterior Subcapsular Cataracts
• Begins at the back of the lens (posterior pole) & spreads to the
periphery or edges of the lens.
• It can be developed when:
– Part of the eye are chronically inflamed.
– Heavy use of some medications (steroids).
• Affects vision more than other types of cataracts because the light
converges at the back of the lens.
• Anything constrict the pupils (bright light) makes it very difficult
for people with this type of cataract to see.
• Dilating drops useful in this type by keeping the pupils large and
thus allow more light into the eye.
18. Immature Cataract
Lens is partially opaque
Two morphological forms are seen:
1.Cuneiform Cataract:
– Wedge shaped opacities in the peripheral cortex and
progress towards the nucleus.
– Vision is worse in low ambient illumination when the
pupil is dilated.
1.Cupuliform Cataract:
– A disc or saucer shaped opacities beneath the posterior
capsule.
– Vision is worse in bright ambient illumination when the
pupil is constricted.
Lens appears grayish white in color.
Iris shadow can be seen on the opacity with oblique illumination.
19. Mature Cataract
• Lens is completely opaque.
• Vision reduced to just perception of light
• Iris shadow is not seen
• Lens appears pearly white
Right eye mature cataract, with obvious white
opacity at the centre of pupil
20. Hypermature Cataract
• Shrunken and wrinkled anterior capsule due to leakage of water
out of the lense.
• This may take any of two forms:
1.Liquefactive/Morgagnian Type
2.Sclerotic Cataract
21. Liquefactive/Morgagnian Type
• Cortex undergoes auto-lytic liquefaction and turns uniformly
milky white.
• The nucleus loses support and settles to the bottom.
22. Sclerotic Cataract
• The fluid from the cortex gets absorbed
and the lens becomes shrunken.
• There may be deposition of calcific
material on the lens capsule.
• Iridodonesis: Anterior chamber
deepens and iris becomes tremulous.
• The zonules become weak, increasing
the risk of subluxation / dislocation of
lens.
23. Symptoms
• A cataract usually develops
slowly, so:
–Causes no pain.
–Cloudiness may affect only a
small part of the lens
–People may be unaware of any
vision loss.
• Over time, however, as the
cataract grows larger, it:
–Clouds more the lens
–Distorts the light passing
through the lens.
–Impairs vision
• Reduced visual acuity (near
and distant object)
• Glare in sunshine or with
street/car lights.
• Distortion of lines.
• Monocular diplopia.
• Altered colours ( white
objects appear yellowish)
• Not associated with pain,
discharge or redness of the
eye
24. Signs
• Reduced acuity.
• An abnormally dim red reflex is seen when the eye is viewed
with an ophthalmoscope.
• Reduced contrast sensitivity can be measured by the
ophthalmologist.
• Only sever dense cataracts causing severely impaired vision
cause a white pupil.
• After pupils have been dilated, slit lamp examination shows
the type of cataract.
26. Treatment
• Glasses: Cataract alters the refractive power of the natural lens
so glasses may allow good vision to be maintained.
• Surgical removal: when visual acuity can't be improved with
glasses.
• Surgical techniques
– Phacoemulsification method.
– Extracapsular method.
– Intracapsular method
27. Pre-op assesments
• General health evaluation including blood pressure check
• Assessment of patients’ ability to co-operate with the
procedure and lie reasonably flat during surgery
• Instruction on eye drop instillation
• The eyes should have a normal pressure, or any pre-existing
glaucoma should be adequately controlled on medications.
• An operating microscope is needed, in order to reach the lens,
a small corneal incision is made close to the limbus for the
phaco-probe.
• It is important to appreciate anterior chamber depth and to
keep all instruments away from the corneal endothelium in the
plane of the iris.
28. Phacoemulsification in cataract surgery
involves insertion of a tiny, hollowed tip that
uses high frequency (ultrasonic) vibrations to
"break up" the eye's cloudy lens (cataract). The
same tip is used to suction out the lens
.
29.
30. Intra-capsular Cataract Extraction
Intracapsular Cataract Extraction. From the late 1800s
until the 1970s, the technique of choice for cataract
extraction was intracapsular cataract extraction
(ICCE). The entire lens (ie, nucleus, cortex, and
capsule) is removed, and fine sutures close the
incision. ICCE is infrequently performed today;
however, it is indicated when there is a need to
remove the entire lens, such as with a subluxated
cataract (ie, partially or completely dislocated lens).
31. Extra-capsular Cataract Extraction
(ECCE)
• Extracapsular Surgery. Extracapsular cataract
extraction (ECCE) achieves the intactness of
smaller incisional wounds (less trauma to the
eye) and maintenance of the posterior capsule
of the lens, reducing postoperative
complications, particularly aphakic retinal
detachment and cystoid macular edema.
32. Postoperative care after cataract
surgery
• Steroid drops (inflammation)
• Antibiotic drops (infection)
• Avoid
• Very strenuous exertion (rise the pressure in the eyeball)
• Ocular trauma.
33. Complications of cataract surgery
• Infective endophthalmitis
– Rare but can cause permanent severe reduction of vision.
– Most cases within two weeks of surgery.
– Typically patients present with a short history of a
reduction in their vision and a red painful eye.
– This is an ophthalmic emergency.
– Low grade infection with pathogen such as
Propionibacterium species can lead patients to present
several weeks after initial surgery with a refractory uveitis
• Suprachoroidal haemorrhage.
– Severe intraoperative bleeding can lead to serious and
permanent reduction in vision.
34. • Uveitis
– Postoperative inflammation is more common in certain types
of eyes for example in patients with diabetes or previous
ocular inflammatory disease.
• Ocular perforation.
• Postoperative refractive error
– Most operations aim to leave the patient emmetropic or
slightly myopic, but in rare cases biometric errors can occur
or an intraocular lens of incorrect power is used.
• Posterior capsular rupture and vitreous loss
– If the very delicate capsular bag is damaged during surgery
or the fine ligaments (zonule) suspending the lens are weak
(for example, in pseudoexfoliation syndrome), then the
vitreous gel may prolapse into the anterior chamber. This
complication may mean that an intraocular lens cannot be
inserted at the time of surgery. Patients are also at increased
risk of postoperative retinal detachment.
35. • Retinal detachment.
– This serious postoperative complication is, fortunately rare,
but is more common in myopic patients after intraoperative
complications.
• Cystoid macular oedema
– Accumulation of fluid at the macula postoperatively can
reduce the vision in the first few weeks after successful
cataract surgery. In most cases this resolves with treatment
of the post-operative inflammation.
• Glaucoma
– Persistently elevated intraocular pressure may need
treatment postoperatively.
• Posterior capsular opacification
– Scarring of the posterior part of the capsular bag, behind
the intraocular lens, occurs in up to 20% of patients. Laser
capsulotomy may be needed.