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Cataracts



        Normal Eye              Cataract

12/7/2006      SURES - IN HOUSE CLINIC   1
What is a Cataract?
  An ocular opacity, partial or complete, of one or both
  eyes, on or in the lens or capsule, especially an opacity
  impairing vision or causing blindness.
  The subsequent cloudy appearance of the eye resulted
  in the origin of the name cataract




12/7/2006          SURES - IN HOUSE CLINIC   2
Cataract Development
• The lens is made mostly of water and protein.
  The protein is normally arranged to let light pass
  through and focus on the retina.
       Protein clumps together
        • Small areas of lens begin to cloud
        • Light is blocked from reaching the retina and vision is
          impaired

        You would be able to see
        light and dark and maybe
        distinguish large objects
        and see movement.
    An advanced stage cataract would be something like putting
    sheets of wax paper over your glasses


12/7/2006              SURES - IN HOUSE CLINIC       3
Cataract Formation
1. Early Stages – change prescription
2. Late Stages – surgical removal
    It is 90% effective for age-related cataracts
            – For secondary, traumatic and congenital cataracts
              surgery is not always an option


• Once a cataract begins to develop there is
  nothing that can be done to prevent its
  growth.
12/7/2006              SURES - IN HOUSE CLINIC       4
Types of Cataracts
• There are four different types of cataracts
    1. Age-related cataract: Most cataracts are related to
      aging
    2. Congenital cataracts: Some babies are born with
      cataracts or develop them in childhood, often in both
      eyes. These can lead to blindness or may not affect
      vision at all
    3. Secondary cataract: Development in people who
      have certain other health issues, such as diabetes
      or things such as steroid use
    4. Traumatic cataract: cataracts which develop after
      an eye injury
12/7/2006           SURES - IN HOUSE CLINIC   5
What causes a Cataract?
•   This is a somewhat complicated subject
    a) Aging of the lens is caused by oxidation (the formation of
       free radicals)

    b) Free Radicals: A molecule which has lost an electron and
       will do anything to get it back
        •   They attack the protein of the lens, steal a hydrogen and
            cause oxidative damage. This leads to a snowball effect
        •   The protein then clumps together and the lens begins to
            cloud, blocking some light from reaching the retina and
            clouding vision

•   Speed of oxidation is increased by:
        1. Smoking /Alcohol use
        2. Diabetes
        3. Excessive exposure to ultraviolet sunlight


12/7/2006               SURES - IN HOUSE CLINIC         6
What does a mid-stage cataract
           look like?




            The type of cataract you have will


12/7/2006            SURES - IN HOUSE CLINIC     7
What does a late-stage cataract
           look like?




12/7/2006   SURES - IN HOUSE CLINIC   8
How an early stage cataract
           effects vision




12/7/2006    SURES - IN HOUSE CLINIC   9
Symptoms
• Cloudy, fuzzy, foggy or filmy vision
• Changes in the way you see colors
• Problems driving at night because headlights
  seem too bright
• Problems with glare from lamps or the sun
• Frequent changes in your eyeglass prescription
• Double vision
• Better near vision in those who are farsighted
    – As the lens becomes cloudier the optics of the eye
      change this may actually allow people who once
      needed glasses to be able to read without them

12/7/2006           SURES - IN HOUSE CLINIC   10
Cataract Detection
   Eye examination
• Visual acuity test: This eye chart test
  measures how well you see at various
  distances
• Pupil dilation: the pupil is widened with
  eye drops to allow your eye doctor to see
  more of the lens and retina and look for
  other eye problems
• Tonometry: This is a standard test to
  measure fluid pressure inside the eye
12/7/2006      SURES - IN HOUSE CLINIC   11
How are cataracts treated?
• For early cataracts
    – Vision may be improved by:
        • Using different eyeglasses
        • Magnifying lenses
        • Stronger lighting
    – If these measures do not improve quality of life,
      surgery is the only option
            – Involves the removal of the cloudy lens and replacing it with a
              substitute lens
      A cataract needs to be removed only when vision loss
      interferes with everyday activities such as driving,
      reading or watching TV

12/7/2006                SURES - IN HOUSE CLINIC           12
How is a cataract removed?
• Phacoemulsification:
  The most common
  method of removal.
  Phaco involves a small
  incision on the side of the
  cornea. A tiny probe is
  inserted which emits
  ultrasound waves that
  soften and break up the
  cloudy center of the lens
  so it can be removed with
  suction
12/7/2006           SURES - IN HOUSE CLINIC   13
Intraocular Lens
                           • After the lens is
                             removed a clear,
                             artificial lens called an
                             Intraocular lens (IOL)
                             is required. The IOL
                             becomes a
                             permanent part of the
                             eye and must last the
                             rest of the patients life


12/7/2006      SURES - IN HOUSE CLINIC   14
Benefits of Cataract Surgery
• Improvements in activities
    –   Driving
    –   Watching TV
    –   Reading
    –   Working
    –   Moving around
    –   Social activities
    –   Hobbies
    –   Safety
    –   Self-confidence
    –   Independence
12/7/2006              SURES - IN HOUSE CLINIC   15
BUT….




12/7/2006   SURES - IN HOUSE CLINIC   16
Risks of Cataract Surgery
• Possible complications:
    –   High pressure in the eye
    –   Blood collection inside the eye
    –   Infection inside the eye
    –   Artificial lens damage
    –   Drooping eyelids
    –   Retinal detachment
    –   Severe bleeding inside the eye
    –   Swelling or clouding of the cornea
    –   Blindness

    – LOSS OF EYE
12/7/2006              SURES - IN HOUSE CLINIC   17
Epidemiology of Cataracts
• According to the World Health
  Organization cataracts are the number
  one cause of blindness worldwide
    – 50 million persons in the world are BLIND
      from cataracts
        • More then half of people over 65 have cataracts
        • 60% of people over the age of 75 have cataracts

        • If you live long enough you are virtually
          GUARANTEED to develop a cataract

12/7/2006           SURES - IN HOUSE CLINIC   18
Primary Prevention
  Intake of dietary antioxidants prevent
  cataract formation by blocking the
  oxidative modification of the lens


            Vitamins A, C and E
People who had regular daily doses of the antioxidants
Vitamin C and E were 32% less likely to have
developed cataracts

12/7/2006         SURES - IN HOUSE CLINIC   19
VITAMIN A




12/7/2006   SURES - IN HOUSE CLINIC   20
VITAMIN C




12/7/2006   SURES - IN HOUSE CLINIC   21
VITAMIN E




12/7/2006   SURES - IN HOUSE CLINIC   22
What can I do to protect my
               vision?
• Wearing sunglasses and a hat with a brim
  to block ultraviolet sunlight may help to
  delay cataract.
• If you smoke, stop. Researchers also
  believe good nutrition can help reduce the
  risk of age-related cataract.
• They recommend eating green leafy
  vegetables, fruit, and other foods with
  antioxidants
12/7/2006     SURES - IN HOUSE CLINIC   23
What can I do to protect my
            vision? Cont…
• If you are age 60 or older, you should
  have a comprehensive dilated eye exam
  at least once every two years.
• In addition to cataract, your eye care
  professional can check for signs of age-
  related macular degeneration, glaucoma,
  and other vision disorders.
  Early treatment for many eye diseases
  may save your sight.
12/7/2006     SURES - IN HOUSE CLINIC   24
12/7/2006   SURES - IN HOUSE CLINIC   25

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cataract-information

  • 1. Cataracts Normal Eye Cataract 12/7/2006 SURES - IN HOUSE CLINIC 1
  • 2. What is a Cataract? An ocular opacity, partial or complete, of one or both eyes, on or in the lens or capsule, especially an opacity impairing vision or causing blindness. The subsequent cloudy appearance of the eye resulted in the origin of the name cataract 12/7/2006 SURES - IN HOUSE CLINIC 2
  • 3. Cataract Development • The lens is made mostly of water and protein. The protein is normally arranged to let light pass through and focus on the retina. Protein clumps together • Small areas of lens begin to cloud • Light is blocked from reaching the retina and vision is impaired You would be able to see light and dark and maybe distinguish large objects and see movement. An advanced stage cataract would be something like putting sheets of wax paper over your glasses 12/7/2006 SURES - IN HOUSE CLINIC 3
  • 4. Cataract Formation 1. Early Stages – change prescription 2. Late Stages – surgical removal It is 90% effective for age-related cataracts – For secondary, traumatic and congenital cataracts surgery is not always an option • Once a cataract begins to develop there is nothing that can be done to prevent its growth. 12/7/2006 SURES - IN HOUSE CLINIC 4
  • 5. Types of Cataracts • There are four different types of cataracts 1. Age-related cataract: Most cataracts are related to aging 2. Congenital cataracts: Some babies are born with cataracts or develop them in childhood, often in both eyes. These can lead to blindness or may not affect vision at all 3. Secondary cataract: Development in people who have certain other health issues, such as diabetes or things such as steroid use 4. Traumatic cataract: cataracts which develop after an eye injury 12/7/2006 SURES - IN HOUSE CLINIC 5
  • 6. What causes a Cataract? • This is a somewhat complicated subject a) Aging of the lens is caused by oxidation (the formation of free radicals) b) Free Radicals: A molecule which has lost an electron and will do anything to get it back • They attack the protein of the lens, steal a hydrogen and cause oxidative damage. This leads to a snowball effect • The protein then clumps together and the lens begins to cloud, blocking some light from reaching the retina and clouding vision • Speed of oxidation is increased by: 1. Smoking /Alcohol use 2. Diabetes 3. Excessive exposure to ultraviolet sunlight 12/7/2006 SURES - IN HOUSE CLINIC 6
  • 7. What does a mid-stage cataract look like? The type of cataract you have will 12/7/2006 SURES - IN HOUSE CLINIC 7
  • 8. What does a late-stage cataract look like? 12/7/2006 SURES - IN HOUSE CLINIC 8
  • 9. How an early stage cataract effects vision 12/7/2006 SURES - IN HOUSE CLINIC 9
  • 10. Symptoms • Cloudy, fuzzy, foggy or filmy vision • Changes in the way you see colors • Problems driving at night because headlights seem too bright • Problems with glare from lamps or the sun • Frequent changes in your eyeglass prescription • Double vision • Better near vision in those who are farsighted – As the lens becomes cloudier the optics of the eye change this may actually allow people who once needed glasses to be able to read without them 12/7/2006 SURES - IN HOUSE CLINIC 10
  • 11. Cataract Detection Eye examination • Visual acuity test: This eye chart test measures how well you see at various distances • Pupil dilation: the pupil is widened with eye drops to allow your eye doctor to see more of the lens and retina and look for other eye problems • Tonometry: This is a standard test to measure fluid pressure inside the eye 12/7/2006 SURES - IN HOUSE CLINIC 11
  • 12. How are cataracts treated? • For early cataracts – Vision may be improved by: • Using different eyeglasses • Magnifying lenses • Stronger lighting – If these measures do not improve quality of life, surgery is the only option – Involves the removal of the cloudy lens and replacing it with a substitute lens A cataract needs to be removed only when vision loss interferes with everyday activities such as driving, reading or watching TV 12/7/2006 SURES - IN HOUSE CLINIC 12
  • 13. How is a cataract removed? • Phacoemulsification: The most common method of removal. Phaco involves a small incision on the side of the cornea. A tiny probe is inserted which emits ultrasound waves that soften and break up the cloudy center of the lens so it can be removed with suction 12/7/2006 SURES - IN HOUSE CLINIC 13
  • 14. Intraocular Lens • After the lens is removed a clear, artificial lens called an Intraocular lens (IOL) is required. The IOL becomes a permanent part of the eye and must last the rest of the patients life 12/7/2006 SURES - IN HOUSE CLINIC 14
  • 15. Benefits of Cataract Surgery • Improvements in activities – Driving – Watching TV – Reading – Working – Moving around – Social activities – Hobbies – Safety – Self-confidence – Independence 12/7/2006 SURES - IN HOUSE CLINIC 15
  • 16. BUT…. 12/7/2006 SURES - IN HOUSE CLINIC 16
  • 17. Risks of Cataract Surgery • Possible complications: – High pressure in the eye – Blood collection inside the eye – Infection inside the eye – Artificial lens damage – Drooping eyelids – Retinal detachment – Severe bleeding inside the eye – Swelling or clouding of the cornea – Blindness – LOSS OF EYE 12/7/2006 SURES - IN HOUSE CLINIC 17
  • 18. Epidemiology of Cataracts • According to the World Health Organization cataracts are the number one cause of blindness worldwide – 50 million persons in the world are BLIND from cataracts • More then half of people over 65 have cataracts • 60% of people over the age of 75 have cataracts • If you live long enough you are virtually GUARANTEED to develop a cataract 12/7/2006 SURES - IN HOUSE CLINIC 18
  • 19. Primary Prevention Intake of dietary antioxidants prevent cataract formation by blocking the oxidative modification of the lens Vitamins A, C and E People who had regular daily doses of the antioxidants Vitamin C and E were 32% less likely to have developed cataracts 12/7/2006 SURES - IN HOUSE CLINIC 19
  • 20. VITAMIN A 12/7/2006 SURES - IN HOUSE CLINIC 20
  • 21. VITAMIN C 12/7/2006 SURES - IN HOUSE CLINIC 21
  • 22. VITAMIN E 12/7/2006 SURES - IN HOUSE CLINIC 22
  • 23. What can I do to protect my vision? • Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataract. • If you smoke, stop. Researchers also believe good nutrition can help reduce the risk of age-related cataract. • They recommend eating green leafy vegetables, fruit, and other foods with antioxidants 12/7/2006 SURES - IN HOUSE CLINIC 23
  • 24. What can I do to protect my vision? Cont… • If you are age 60 or older, you should have a comprehensive dilated eye exam at least once every two years. • In addition to cataract, your eye care professional can check for signs of age- related macular degeneration, glaucoma, and other vision disorders. Early treatment for many eye diseases may save your sight. 12/7/2006 SURES - IN HOUSE CLINIC 24
  • 25. 12/7/2006 SURES - IN HOUSE CLINIC 25