Beruflich Dokumente
Kultur Dokumente
Part A
Presentation
Decreased vision in both eyes for 6 months; Watery discharge from both eyes for 5
months
Main diagnosis
Age related cataract
Gender: Female
Summary of examination
On examination, she had symmetrical forehead crease. Eyebrows were normal and no
swelling, redness in eyelids. Torch light examination of both the eyes showed no
congestion in conjunctiva and no opacity and deposits in cornea. Iris was dark brown
in colour with normal pattern. Pupils were round, regular and reactive to light.
Anterior chamber depth was normal.
Opacity was seen in the lens of right eye which was more pronounced than in left eye.
Ocular motility test was normal. Her vision on right eye was 5/6 while left eye was
6/60 unaided. IOP was 13 and 14 on right and left eyes respectively. Her BP was
130/80 mmHg.
Provisional diagnosis
Age related cataract
Summary of investigations
She was sent for Biometry.
Management including medications
No any medication was given.
Management
She was advised for surgery for treatment of cataract- Phacoemulsification with
Intraocular lens.
Part B
What causes this condition (summarize the pathophysiology)?
Cataract is development of opacity in lens or its capsule. It can be congenital or
acquired. Senile cataract is the commonest type of acquired cataract and usually
occurs after 50 years of age. It is usually bilateral and affects both sexes. Senile
cataract is aging process so age is the most important risk factors. Other factors like
heredity, UV radiation exposure, diet deficient in certain proteins, amino acids,
vitamins and essential elements, previous dehydration crises due to diarrhoea and
cholera have role in incidence, age of onset and maturation of the disease. Besides,
smoking is associated with increased frequency of disease.
Morphologically, senile cataract is of two types-cortical where hydration and decrease
synthesis of protein followed by denaturation of proteins occurs primarily in cortex
and nuclear cataract where slow sclerosis occurs in nucleus of lens.
As the cataract is a gradually progressing disease, maturation of cataract takes place in
following stages:
Maturation of cortical type of senile cataract:
Stage of lamellar separation
Stage of incipient cataract
Immature senile cataract
Mature senile cataract
Hyper-mature senile cataract
Surgical management
Intracapsular cataract extraction
Extracapsular cataract extraction
Conventional extracapsular cataract extraction
Manual small incision cataract surgery
Phaecoemulsification
Laser phaecoemulsification