Cataracts are lens opacities that can occur in one or both eyes and are influenced by various risk factors such as smoking and diabetes. The main types of cataracts include nuclear, cortical, and posterior subcapsular, which can cause symptoms like blurry vision and light sensitivity. Medical management lacks non-surgical treatments, while surgery is recommended when vision impairment affects daily activities, typically involving phacoemulsification and lens replacement under local anesthesia.

1. CATARACT
SWATILEKHA DAS, RN
B.Sc (H)Nursing, M.Sc
(MSN)
ASST. PROFESSOR

2. DEFINITION
A cataract is a lens opacity or cloudiness.
Cataracts can develop in one or both eyes and at
any age.

3. RISK FACTORS
Cigarette smoking
Long-term use of corticosteroids, especially at
high doses
Sunlight and ionizing radiation
Diabetes
Obesity
Eye injuries can increase the risk of cataracts.

4. TYPES
The three most common types of senile (age-
related) cataracts are defined by their location in
the lens: nuclear, cortical, and posterior
subcapsular.
Visual impairment depends on the size, density,
and location in the lens. More than one type can
be present in one eye.

5. CLINICAL MANIFESTATIONS
• Painless, blurry vision.
• Perception that surroundings are dimmer (as if
glasses need cleaning).
• Light scattering; reduced contrast sensitivity,
sensitivity to glare, and reduced visual acuity.

6. Other effects include myopic shift (return of
ability to do close work [eg, reading fine print]
without eyeglasses), astigmatism, monocular
diplopia (double vision), color shift (the aging
lens becomes progressively more absorbent at
the blue end of the spectrum), brunescens
(color values shift to yellow-brown), and
reduced light transmission.

7. DIAGNOSTIC STUDIES
• Degree of visual acuity is directly
proportionate to density of the cataract.
• Snellen visual acuity test.
• Ophthalmoscopy.
• Slit-lamp biomicroscopic examination.

8. MEDICAL MANAGEMENT
No nonsurgical (medications, eyedrops,
eyeglasses) treatment cures cataracts or prevents
age-related cataracts
Studies have found no benefit from antioxidant
supplements, vitamins C and E, beta-carotene, and
selenium
Glasses or contact, bifocal, or magnifying lenses
may improve vision.
Mydriatics can be used short term, but glare is
increased.

9. SURGICAL MANAGEMENT
In general, if reduced vision from cataract does
not interfere with normal activities, surgery may
not be needed.
In deciding when cataract surgery is to be
performed, the patient’s functional and visual
status should be a primary consideration.

10. Surgical options include phacoemulsification
(method of extracapsular cataract surgery) and lens
replacement (aphakic eyeglasses, contact lenses,
and intraocular lens implants).
Cataracts are removed under local anesthesia on
an outpatient basis. When both eyes have
cataracts, one eye is treated first, with at least
several weeks, preferably months, separating the
two procedures.

12. NURSING MANAGEMENT
• Withhold any anticoagulants the patient is
receiving, if medically appropriate. In some cases,
anticoagulant therapy may continue.
• Administer dilating drops every 10 minutes for
four doses at least 1 hour before surgery. Antibiotic,
corticosteroid, and anti-inflammatory drops may be
administered prophylactically to prevent
postoperative infection and inflammation.

13. • Provide patient verbal and written instructions
about how to protect the eye, administer
medications, recognize signs of complications, and
obtain emergency care.
• Explains that there should be minimal discomfort
after surgery, and instruct the patient to take a mild
analgesic agent, such as acetaminophen, as needed.
• Antibiotic, anti-inflammatory, and corticosteroid
eye drops or ointments are prescribed
postoperatively