final cataract_ppt

8/7/2019 final cataract_ppt

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cataract derives from the Latin cataractameaning "waterfall" and the Greek kataraktesand katarrhaktes, from katarassein meaning "to

dash down" (kata -, "down"; arassein , "to

strike, dash").

As rapidly running water turns white, the term

may later have been used metaphorically to

describe the similar appearance of mature ocularopacities. In dialect English a cataract is called a

pearl, as in "pearl eye" and "pearl-eyed.


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Gender

Long-term exposure to ultraviolet lightage-related 40s and 50s

Immature Senile Cataract (IMSC) - partially

opaque lens, disc view hazy

Mature Senile Cataract (MSC) - Completelyopaque lens, no disc view

Hypermature Senile Cataract (HMSC) lens

protein breakdown into short chain polypeptides

that leak out through the lens capsule. Liquefied

cortical matter: Morgagnian Cataract

ETIOLOGY


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Smoking

Genetic factors are often a cause of congenital

cataracts and positive family history

Congenital cataract

Excessive exposure to radiation coming from

outer space such as Icelandair pilots showed

commercial airline pilots are three times more likely to

develop cataracts than people with non-flying jobs. Common in persons exposed to infrared radiation,

such as glassblowers who suffer from "exfoliation

syndrome".

Exposure to microwave radiation can causecataracts.

Drug induced cataract development, such as

Corticosteroids and Ezetimibe and Seroquel


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Secondary cataract

Traumatic Penetrating trauma (capsular rupture

& leakage of lens material - calls for an

emergency surgery for extraction of lensand leaked material to minimize further

damage)

Nutrition-nutritional deficiencies of nutrients

include riboflavin, total protein, amino acids,vitamin E, vitamin C, selenium, calcium, zinc


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INCIDENCE

According to the World HealthOrganization, there are about 42

million blind people in the world; of

which 17 million (40%) are blind dueto cataract. In the Philippines with

the estimated population of 86, 241,

6972 the prevalence rate of persons

with cataract is 1,743,857


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PATHOPHYSIOLOGY

Genetic

Gender

Smoking(35 or more packs/ year)

Nutrition

Drug induced

Corticosteroids

age-related 40s and 50s

Long-term exposure to ultraviolet light

Excessive exposure to radiation

Traumatic cataract

Secondary cataract

DM

Decrease oxygen uptake in the

lens

Initial increase in water

content

Predisposing factors Precipitating factors

Dehydration of


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Increase Na, Ca content

decrease K ascorbic acid

and protein content

Yellowing of the lens due to formation of fluorescent compound

and molecular change

Immature cataract

Mature cataract

Intumescent cataract


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If treated: if not treated:

BlindnessSurgical management:

Phacoemulsification,or phaco.

Extracapsular surger

Intra-capsular (ICCE)

surgery

Intraocular lens (IOL)

Compliance

Good Prognosis


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Cloudy or painless blurry vision.

Colors seem faded.

Glare. Headlights, lamps, or sunlight may

appear too bright. A halo may appear around

lights.Poor night vision.

Double vision or multiple images in one eye.

(This symptom may clear as the cataract gets

larger.)Vision is better in dim light with pupil dilation

Absence ofred reflex

SIGNS ANG SYMPTOMS


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1.Visual acuity test

2.Dilated eye exam3.Tonometry

4.Contrast sensitivity test

5.Visual field test

DIAGNOSTIC EXAMS


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6.Ophthalmoscopy

Direct ophthalmoscopy. Indirect

ophthalmoscopy..

7.Slit lamp test

8.Glare test


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Prevention

Although cataracts have no scientifically proven prevention, it issometimes said that wearing ultraviolet-protecting sunglasses may

slow the development of cataracts. Regular intake of antioxidants

(such as vitamin A, C and E) is theoretically helpful, but taking them

as a supplement has been shown to have no benefit.

Treatment

The symptoms of early cataract may be improved with:

new eyeglasses

brighter lighting

Anti-glare sunglasses or magnifying lenses.

MEDICAL MANAGEMENT


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1.Phacoemulsification, orphaco

2. Extracapsularsurgery

3. Intra-capsular (ICCE) surgery

4. Intraocular lens (IOL)

5.YAG laser capsulotomy

SURGICAL MANAGEMENT


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Risk of cataract surgery

Infection and bleeding

Retinal detachment

Endophthalmitis

Posterior capsular opacification

Inflammation (pain, redness, swelling), loss ofvision, double vision, and high or low eye pressure

Eye tissue that encloses the IOL becomes cloudy

and may blur your vision. This condition is called an

after-cataract. An after-cataract can develop monthsor years after cataract surgery.


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Happens before surgery?

A week or two before surgery, doctor will do

some tests. These tests may include

measuring the curve of the cornea and thesize and shape of your eye. This information

helps the doctor choose the right type of IOL

may be asked not to eat or drink anything 12

hours before your surgery.


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Happens during surgery?drops will be put into your eye to dilate the pupil.

The area around your eye will be washed andcleansed.

The operation usually lasts less than one hour and is

almost painless.

If awake, an anesthetic to numb the nerves in andaround eye.

After the operation, a patch may be placed over your

eye.

You will rest for a while.medical team will watch for any problems, such as

bleeding. Most people who have cataract surgery can

go home the same day.

will need someone to drive you home.


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Happens after surgery?Itching and mild discomfort

Some fluid discharge

sensitive to light and touch

After one or two days, moderate discomfort should

disappear.

need to wear an eye shield or eyeglasses to help

protect your eye. Avoid rubbing or pressing on your eye.

When you are home, try not to bend from the waist to

pick up objects on the floor.

Do not lift any heavy objects. You can walk, climb stairs,

and do light household chores.

In most cases, healing will be complete within eight

weeks.


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Sensory/perceptual alteration (visual) related to lensextraction and replacement

NURSING MANAGEMENT

Fearrelated toupcoming surgery and potential failure attain

improved vision

Acute pain related to increased intraocular pressure

Risk for infection related to increased susceptibility to

surgical interruption of body surfaces

Risk for injury related to visual limitations and presence in

an unfamiliar environment


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Pre-op nursing care1. Instruct measures to prevent or decrease IOP

Avoid heavy lifting, violent coughing, bending lower the waist, reading (but

watching tv is allowed).

Avoid prolonged anger and sexual activity

2. Administer pre-op eye medications including mydriatics and cycloplegics

as prescribed. Ex: atropine

Post-op nursing care1. Elevate the head of the bead 30-45 degrees

2. Turn the client to the back or unoperative side3. Pharmacologic: antibiotic-steroids

4. No aspirin due to clotting effect

5. Instruct measures to prevent or decrease IOP

6. Wear glasses during the day until the pupils responds to light

7. Eye shield at night or while sleeping

8. For minor pain: ice or heat as prescribed9. Shower or bathing is allowed

10.Care of the dressings

11.Stool softeners

12.Instruct to report pain with nausea and vomiting.

final cataract_ppt

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