Definition

• A cataract is a disorder in which opacity (cloudiness) in the lens of the eye and degeneration of lens fibers, lead to blurred vision.
• A cataract occurs due to hydration, denaturation of lens protein, and sclerosis.

• A cataract is the most common cause of blindness.

Cataract classification

1. According to etiology  

1. Acquired cataract

• Acquired cataracts commonly occur.
•  Acquired cataract are
  • Senile cataract
  • Metabolic cataract
  • Complicated cataract
  • Traumatic cataract

  • Cataracts

    associated with skin disease

  • Drug Induced cataract
  • Cataract with miscellaneous syndrome
  • Electric cataract.

2. Developmental cataract  

• Also known as the congenital cataract occurs due to disturbance in normal development of the lens.
• Generally development cataracts occur in the infancy to adolescence, due to genetic disorders.

     2.   According to morphology

1. Subcapsular cataract – anterior subcapsular cataract.

• Posterior subcapsular cataract.

2. Cortical cataract –

a cataract occurs due to wedge shape or radial spoke like opacities of lens.

• Occur outer edge of the lenses.

3. Nuclear cataract –

a cataract occurs in the center of the lens.

• Yellow to Brown coloration.

Causes of Cataract

• Hereditary
• Family history
• Age factors
• Malnutrition during pregnancy
• Radiation exposure
• Excessive use of corticosteroids
• Down syndrome
• Skeletal syndrome
• Chromosome abnormality
• Birth trauma
• Infection
• Diabetes mellitus
• Trauma
• Marfan syndrome
• Previous ocular surgery
• Wilson disease.

Pathophysiology of Cataract

Cause / Etiology

↓

Traumatic damage the lens fibres

↓

Rupture lens capsule

↓

Hydration of lens fibers

↓

Opacity of lens.

 

Signs/Symptoms of Cataract

Clinical manifestation of

Cataract Clinical manifestation

• Cloudy vision
• Blurred vision
• Photophobia ( sensitive to light )
• Double vision
• Monocular diplopia
• Glare
• Distortion of lines
• Reduce visual acuity
• Dim red reflex
• Poor vision at night
• Decrease colour perception
• White pupil.

Diagnostic examination of Cataract

• History collection and physical examination.
• Direct ophthalmoscope examination.
• Snailing visual acuity test.
• Slit lamp examination.
• Tonometry.
• Retinal examination.

Medical management of Cataract

• Use glasses
• Optical aids
• Pupillary dilation
• Topical steroids
• Antibiotics drops
• Steroid drops.

Surgical management of Cataract

1. Intracapsular extraction – remove the whole lens and surround it.
2. Extracapsular extraction – only cataract removal.
3. Cryosurgery
4. Phacoemulsification – emulsifying of the lens by a hollow needle vibrating and ultrasonic speed.

Complication – Blindness.

 

Nursing management

• Nurses monitor patients’ visual acuity and vital signs.
• Examine the complete morphology of lens opacity under slit lamp examination.
• Examine the cornea to find out any opacity of the lens.
• Monitor intraocular pressure (IOP).
• Nurses also assess pupillary response.
• The nurse performed the cover test.
• Use a nursing barrier to prevent infection.
• Nurses assist the client during any activity.
• Provide instruction about cataract patient care and Management.
• Nurses help to conduct diagnostic examinations.
• Provide adequate medications and other required treatment.
• Provide emotional and physiological support and reduce anxiety.
• Prepare the client for surgical intervention.
• Administer local anesthesia with sedation before surgery.
• Nurse counseling to relieve patient anxiety.

 

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