Cataracts Lecture Notes

Introduction

• Cataracts: Eye disorder where the lens loses transparency and becomes cloudy.
• Affects light transmission to the retina, causing cloudy vision.

Normal Vision vs. Cataract Vision

• Normal Vision: Light focuses on the retina for a clear image.
• Cataract Vision: Light scatters due to a cloudy lens, resulting in blurred and less vibrant images.

Prevalence

• Common in older adults.
• Over half of Americans aged 80+ have or had cataracts.

Pathophysiology

• Eye Structure:
  • Light enters through the cornea, passes through the pupil, and hits the lens.
  • The lens is supported by ciliary muscles, aiding in focusing.
• Lens Clarity:
  • Clear due to crystalline proteins.
  • Cataracts occur when proteins clump, clouding the lens.

Causes

• Age: Senile cataracts due to aging.
• Congenital: Infections like rubella during pregnancy.
• Trauma and Diseases: Diabetes, unprotected sunlight exposure.
• Medications: Corticosteroids.
• Lifestyle: Smoking, alcohol, family history.

Symptoms

• Mnemonic "CATS":
  • C: Cloudy/blurred vision, double vision.
  • A: Frequent changes in eyeglass prescription.
  • T: Toned down colors.
  • S: Sensitivity to glare/light, halos around lights.

Diagnosis

• Visual Acuity Test: Using Snellen chart.
• Slit Lamp Examination: Enlarges view of eye structures.
• Dilated Eye Exam: Allows detailed optic nerve assessment.

Treatment

• Monitoring: Regular eye exams, updated prescriptions, anti-glare glasses.
• Surgery: Phacoemulsification - removal of cloudy lens and insertion of intraocular lens.
  • Minimal incision, no sutures.

Nursing Role

Prevention

• Education: "LENS" Mnemonic:
  • L: Layers of protection, sunglasses, hats.
  • E: Eat fruits/vegetables for nutrients.
  • N: No smoking, limit alcohol.
  • S: Schedule regular eye exams.

Pre-Surgery

• Educate on procedure, outpatient nature, need for driver.
• Pre-surgery eye drops: Anti-inflammatories, antibiotics.
• Medication Review: Alert doctor about alpha-blockers like tamsilosin.

Post-Surgery Care

• Positioning: On non-surgical side.
• Protection: Eye shields/glasses.
• Activity Restrictions: No heavy lifting, bending, or swimming.
• Pain Management: Minimal pain expected.
• Complication Signs: Severe pain, vision decrease, flashes, or abnormal drainage.

Conclusion

• Cataract surgery is generally successful in restoring vision.
• Regular appointments are crucial for monitoring recovery.