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AccordIng to WHD defInItIon: "Cataract Is cIoudIng of the Iens of

the eye whIch Impedes the passage of IIght. A cataract is a painIess.


other types of cataract?
Secondary cataract. Cataracts can form after surgery for other
eye problems,
2 %raumatic cataract. Cataracts can develop after an eye injury,
sometimes years later
3 ongenital cataract. Some babies are born with cataracts or
develop in childhood, often in both eyes
4 adiation cataract. Cataracts can develop after exposure to
some types of radiation
symptoms of cataracts?
Cloudy or 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
These symptoms also can be a sign of other eye problems If
you have any of these symptoms, check with your eye care
professional

Cataract surgery separates the cataract from the Iens capsuIe. In
most cases, the Iens wiII be repIaced with an intraocuIar Iens
impIant (IOL).
Cataract surgery is generally performed with minimal sedation and
generally takes less than 30 minutes.
There are three basic techniques for cataract surgery:
1. PhacoemuIsification: cataract surgery can usually be performed in
less than 30 minutes AND numbing eye drops, no stitches to close the
wound, no eye patch after surgery.

2. ExtracapsuIar cataract surgery: This procedure is used mainly for
very advanced cataracts where the lens is too dense to dissolve into
fragments (phacoemulsify).
3. IntracapsuIar cataract surgery: This surgical technique requires an
even larger wound than extracapsular surgery.
What happens before surgery?

O A week or two before surgery, your doctor will do some
tests
O You may be asked not to eat or drink anything 2 hours
before your surgery

What happens during surgery?

O At the hospital or eye clinic, drops will be put into your eye
to dilate the pupil
O The operation usually lasts less than one hour and is almost
painless
O If you are awake, you will have an anesthetic
O After the operation, a patch may be placed over your eye

What happens after surgery?

O Itching and mild discomfort are normal after cataract
surgery
O For a few days after surgery, your doctor may ask you to
use eyedrops
O Avoid rubbing or pressing on your eye
O When you are home, try not to bend from the waist to pick
up objects on the floor
O Do not lift any heavy objects You can walk, climb stairs,
and do light household chores
O In most cases, healing will be complete within eight weeks











Are there other types of cataract?
Yes Although most cataracts are related to aging, there are other
types of cataract:
5 Secondary cataract. Cataracts can form after surgery for other
eye problems,
6 %raumatic cataract. Cataracts can develop after an eye injury,
sometimes years later
7 ongenital cataract. Some babies are born with cataracts or
develop in childhood, often in both eyes
8 adiation cataract. Cataracts can develop after exposure to
some types of radiation
What are the symptoms of cataracts?
Cloudy or 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
These symptoms also can be a sign of other eye problems If
you have any of these symptoms, check with your eye care
professional
O What happens before surgery?
O A week or two before surgery, your doctor will do some
tests These tests may include measuring the curve of the
cornea and the size and shape of your eye This information
helps your doctor choose the right type of IOL
O You may be asked not to eat or drink anything 2 hours
before your surgery
O What happens during surgery?
O At the hospital or eye clinic, drops will be put into your eye
to dilate the pupil The area around your eye will be washed
and cleansed
O The operation usually lasts less than one hour and is almost
painless Many people choose to stay awake during surgery
Others may need to be put to sleep for a short time
O If you are awake, you will have an anesthetic to numb the
nerves in and around your eye
O After the operation, a patch may be placed over your eye

O What happens after surgery?
O Itching and mild discomfort are normal after cataract
surgery Some fluid discharge is also common Your eye
may be sensitive to light and touch
O For a few days after surgery, your doctor may ask you to
use eyedrops to help healing and decrease the risk of
infection Avoid rubbing or pressing on your eye
O 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
O In most cases, healing will be complete within eight weeks
Your doctor will schedule exams to check on your progress
at sould I do after surgery?
O It is important not to squeeze your eye the first couple
of days after surgery
O No bandages are required so the patient walks out of
the operating room by his own means even though
vision will be blurry for 2 or 3 days
O Eyedrops will be prescribed for 2 to 3 weeks
O Two weeks after surgery you will be able to perform
any activity without risk
NURSING MANAGEMENT
8ecause surgery ls performed on an ouLpaLlenLs basls
O lnsLrucL paLlenL Lo make arrangemenLs for LransporLaLlon home care LhaL
evenlng and a followup vlslL Lo Lhe surgeon Lhe nexL day
O AdmlnlsLer dllaLlng drops every 10 mlnuLes for four doses aL leasL 1 hour
before surgery
O AnLlbloLlc corLlcosLerold and nSAlu drops may be admlnlsLered
prophylacLlcally Lo prevenL posLoperaLlve lnfecLlon and lnflammaLlon
O lnsLrucL paLlenL Lo wear a proLecLlve eye paLch for 24 hours afLer surgery Lo
prevenL accldenLal rubblng or poklng of Lhe eye
O AfLer 24 hours eyeglasses (sunglasses ln brlghL llghL) should be worn
durlng Lhe day and a meLal shleld worn aL nlghL for 1 Lo 4 weeks
O rovlde posLoperaLlve dlscharge Leachlng concernlng eye medlcaLlons
cleanslng and proLecLlon acLlvlLy level and resLrlcLlons dleL paln conLrol
poslLlonlng
O lnsLrucL paLlenL Lo resLrlcL bendlng and llfLlng heavy ob[ecLs
O CauLlon paLlenL LhaL vlslon may blur for several days Lo weeks
O lnform paLlenL LhaL vlslon gradually lmproves as Lhe eye heals

















What is a cataract?
A cataract is a painIess, cIoudy area in the Iens of the eye. The Iens is encIosed in a Iining caIIed
the Iens capsuIe. Cataract surgery separates the cataract from the Iens capsuIe. In most cases,
the Iens wiII be repIaced with an intraocuIar Iens impIant (IOL). If an IOL cannot be used, contact
Ienses or eyegIasses must be worn to compensate for the Iack of a naturaI Iens.
Cataracts occur when the natural clear lens inside the eye, located behind the iris, becomes cloudy
over time. This lens is important for focusing light on the back of the eye (the retina) so that images
appear clear and without distortion, and the clouding of this lens during cataract formation distorts
our vision.
Cataracts are usually a very gradual process of normal aging but can occasionally develop rapidly.
They commonly affect both eyes, but it is not uncommon for a cataract in one eye to advance more
rapidly. Cataracts are very common, affecting roughly 60% of people over the age of 60, and over
1.5 million cataract surgeries are performed in the United States each year.
. Rarely, cataracts can present at birth or in early childhood as a result of hereditary enzyme defects.
Severe trauma to the eye, eye surgery, or intraocular inflammation can also cause cataracts to
develop more rapidly. Other factors that may lead to development of cataracts at an earlier age
include excessive ultraviolet light exposure, diabetes, smoking, or the use of certain medications,
such as oral, topical, or inhaled steroids. Other medications that are more weakly associated with
cataracts include the long-term use of statins andphenothiazines.
What are the symptoms of cataracts?
Cataract development is often equated to looking through a dirty windshield of a car or smearing
grease over the lens of a camera.
Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty
with glare (often with bright sun or automobile headlights while driving at night), dull color vision,
increased nearsightedness accompanied by frequent changes in eyeglass prescription, and
occasionally double vision in one eye. A change in glasses may help initially once vision begins to
change from a cataract; however, as the cataract continues to grow, vision becomes cloudy, and
stronger glasses or contact lenses will no longer improve sight.
The abnormal lens can be seen using a variety of specialized viewing instruments. Using a variety of
tests, your doctor is able to tell how much a cataract may be affecting your vision. Usual eye tests
include testing visual acuity, glare sensitivity, color vision, contrast sensitivity, and a thorough
examination of all other parts of the eye. The development of cataracts is unpredictable; some
cataracts remain small and never progress to the point where they affect vision and require
treatment, while others progress more quickly.
Who is a candidate for cataract surgery?
Surgery is recommended for most individuals who have vision loss and are symptomatic from a
cataract. Cataract surgery is generally performed with minimal sedation and generally takes less
than 30 minutes. Therefore the surgery does not put significant strain on the heart or the lungs.
What are the different types of cataract surgery? SURGICAL
MANAGEMENT
here are three basic techniques for cataract surgery:
1. PhacoemuIsification: This is the most common form of cataract removal. n this most modern
method, cataract surgery can usually be performed in less than 30 minutes and usually requires only
minimal sedation and numbing eye drops, no stitches to close the wound, and no eye patch after
surgery.

2. ExtracapsuIar cataract surgery: This procedure is used mainly for very advanced cataracts where
the lens is too dense to dissolve into fragments (phacoemulsify). This technique requires a larger
incision so that the cataract can be removed in one piece without being fragmented inside the eye..
This surgical technique requires a various number of sutures to close the larger wound, and visual
recovery is often slower. Extracapsular cataract extraction usually requires an injection of numbing
medication around the eye and an eye patch after surgery.

3. IntracapsuIar cataract surgery: This surgical technique requires an even larger wound than
extracapsular surgery, and the surgeon removes the entire lens and the surrounding capsule together.
This technique requires the intraocular lens to be placed in a different location, in front of the iris. This
method is rarely used today but can be still be useful in cases of significant trauma.
What shouId one expect prior to and on the day of cataract surgery?
t is important to remember to follow all of your preoperative instructions, which will usually include
O not eating or drinking anything after midnight the day prior to your surgery.
O As cataract surgery is an outpatient procedure, arrangements should be made with family or
friends to transport you home after the surgery is complete .
O Most cataract surgery is done with only minimal anesthesia and numbing drops without
having to put you to sleep.
. While cataract surgery does not involve a significant amount of pain, medications are used to
minimize the amount of discomfort.
The actual removal of the clouded lens will take approximately 20 minutes. You may notice the
sensation of pressure from the various instruments used during the procedure. After leaving the
operating room, you will be brought to a recovery room where your doctor will prescribe several eye
drops that you will need to take for a few weeks postoperatively. While you may notice some
discomfort, most patients do not experience significant pain following surgery; if you do you
experience decreasing vision or significant pain, you should contact your ophthalmologist
immediately.
What shouId one expect after the cataract surgery?
Following surgery, you will need to return for visits within the first few days and again within the first
few weeks after surgery.
During this time period, you will be using several eye drops which help protect against infection and
inflammation. Within several days, most people notice that their vision is improving and that they are
able to return to work.
During the several office visits that follow, your doctor will monitor for complications, and once vision
has stabilized, will fit you with glasses if needed.
What are potentiaI compIications of cataract surgery?
The most common difficulties arising after surgery are persistent inflammation, changes in eye
pressure, infection, or swelling of the retina at the back of the eye, and retinal detachment intraocular
lens moves or does not function properly and may need to be repositioned, exchanged, or removed.
There can be loss of vision, bleeding, double vision and infection Inflammation and fluctuating eye
pressure can be a side effect of this surgery as well

Secondary cataracts are cataracts that develop years after cataracts surgery It is a condition that
clouds the back of the lens capsule This is part of the lens that wasn't removed during the first
surgery and that supports the lens implant (IOL) This condition can also be called 'aftercataracts' and
posterior capsule opafication

.
Cataracts At A Glance
O Early symptoms of cataracts include blurred vision, glare, and difficulty reading.
O Cataracts will affect most people and become more prominent as we age.
O Cataracts can be diagnosed when the doctor examines the eyes with specialized viewing
instruments.
O The decision to proceed with surgery is primarily based on the amount of difficulty you have
performing your routine daily activities.
O Treatment for cataracts is surgical removal of the cataract with implantation of an artificial lens.
O There are a variety of intraocular lens types that can restore vision in different ways.
at sould I do after surgery?
O It is important not to squeeze your eye the first couple of days
after surgery
O No bandages are required so the patient walks out of the
operating room by his own means even though vision will be
blurry for 2 or 3 days
O Eyedrops will be prescribed for 2 to 3 weeks
O Two weeks after surgery you will be able to perform any activity
without risk
Posterior CapsuIe Opacity - A Common Cataract Surgery CompIication
One of the most common cataract surgery complications is a posterior capsule opacity (also called posterior capsule
opacification or PCO). Although some people call PCO a "secondary cataract," it really is not a cataract. Once a
cataract is removed, it does not come back.
During cataract surgery, your surgeon will remove the cloudy natural lens of your eye (cataract) and replace it with
an intraocuIar Iens (OL). Much of the thin clear membrane that surrounds the natural Iens (called the lens capsule)
is left intact during surgery and the OL usually is implanted within it.

Some complications can be treated and vision loss reversed, but others cannot. Potential complications that
may occur with cataract surgery include:
O nfection in the eye (endophthalmitis).
O Swelling and fluid in the center of the nerve layer (cystoid macular edema).
O Swelling of the clear covering of the eye (corneal edema).
O Bleeding in the front of the eye (hyphema).
O Bursting (rupture) of the capsule and loss of fluid (vitreous gel) in the eye.
O Detachment of the nerve layer at the back of the eye (retinal detachment).

NURSING MANAGEMENT
8ecause surgery ls performed on an ouLpaLlenLs basls
O lnsLrucL paLlenL Lo make arrangemenLs for LransporLaLlon home care LhaL evenlng and a
followup vlslL Lo Lhe surgeon Lhe nexL day
O WlLhhold any anLlcoagulanLs Lhe paLlenL ls recelvlng lf medlcally approprlaLe Asplrln should be
wlLhheld for 3 Lo 7 days nonsLeroldal anLllnflammaLory drugs (nSAlus) for 3 Lo 3 days and
warfarln (Coumadln) unLll Lhe proLhrombln Llme of 13 ls almosL reached
O AdmlnlsLer dllaLlng drops every 10 mlnuLes for four doses aL leasL 1 hour before surgery
O AnLlbloLlc corLlcosLerold and nSAlu drops may be admlnlsLered prophylacLlcally Lo prevenL
posLoperaLlve lnfecLlon and lnflammaLlon
O lnsLrucL paLlenL Lo wear a proLecLlve eye paLch for 24 hours afLer surgery Lo prevenL accldenLal
rubblng or poklng of Lhe eye AfLer 24 hours eyeglasses (sunglasses ln brlghL llghL) should be
worn durlng Lhe day and a meLal shleld worn aL nlghL for 1 Lo 4 weeks
O rovlde posLoperaLlve dlscharge Leachlng concernlng eye medlcaLlons cleanslng and
proLecLlon acLlvlLy level and resLrlcLlons dleL paln conLrol poslLlonlng
O lnsLrucL paLlenL Lo resLrlcL bendlng and llfLlng heavy ob[ecLs
O CauLlon paLlenL LhaL vlslon may blur for several days Lo weeks
O lnform paLlenL LhaL vlslon gradually lmproves as Lhe eye heals

Cataracts are classified by the cause:
O Senile cataracts develop in elderly people
O Congenital cataracts occur in neonates from inborn errors of metabolism or
O from maternal rubella infection during the first trimester
O Complicated cataracts occur secondary to uveitis, glaucoma, retinitis pigmentosa, or retinal
detachment
O Toxic cataracts result from drug or chemical toxicity with prednisone,
Interventions NursingCarePIans ForCataract

O Postoperatively, monitor the patient until he recovers from the effects of the anesthetic.
O Keep the side rails of the bed up, monitor vital signs, and assist him with early ambulation.
O Apply an eye shield or eye patch postoperatively as ordered
O Communication enhancement: Visual deficit; Activity therapy; Cognitive stimulation;
Environmental management; Fall prevention; Surveillance: Safety

Nursing Care PIans For Cataract Home HeaIth:

O Caution him to avoid activities that increase intraocular pressure, such as straining with coughing,
bowel movements, or lifting
O Clients fitted with cataract eyeglasses. The eyeglasses should be first used when the patient is
seated, until the patient adjusts to the distortion.
O nstruct the client to look through the center of the corrective lenses and to turn the head, rather
than only the eyes, when looking to the side.
O Teach the patient or family member how to instill ophthalmic ointment or drops.

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