Understanding Cataracts and Their Impact

Oct 24, 2024

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.