CATARACT

Prof. K MALU

• Cataract is the leading cause of blindness globally.
• 51% of blindness globally is as a result of cataract.

Cataract morphology

Assessment

General

• History of white pupil
• Loss of visual attention,
• Assess density of cataract,
• Observe fundal reflex- absence or reduction will indicate cataract is

visually significant.

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• Perform dilated fundus examination with ophthalmoscope.
• Examine other associated ocular anomalies:
• absence of central

fixation, nystagmus, strabismus, corneal clouding, microphthalmos,

glaucoma, retinoblastoma, retinal pathology.

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Assessment

Investigation

• Serological tests for intra-utrine infections (TORCH toxoplasmosis, rubella, cytomegalovirus and herpes simplex)
• History of maternal rash during pregnancy for varicella zoster antibody titers.
• Urinalysis for galactocemia and chromatography for amino acids
• Refer for Pediatrician to rule out systemic diseases.

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Assessment

• Assess visual acuity and review the report of refraction.
• Surgery is required when cataract has progressed to the point of causing difficulty in performance of daily activities.
• Asses complete morphology of opacity( size, site, shape, color and pattern) under slit lamp examination.
• Perform cover test.

Assessment

• Test pupillary response
• Examine the corneal to rule out any opacities
• Examine ocular adnexal
• Perform a dilated fundus examination
• Perform USG B-scan
• Measure intraocular pressure
• Perform acuity potential measurement
• Perform biometry.

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Assessment

• Specular microscopy(endothelial cells)
• A normal cell count is more than >2400 cells/mm2
• If cell count is fewer than <1000/mm2 there is risk of postoperative corneal decompensation.

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