Cataract

(Penyakit Mata)
By : PPPP Hazwan
 What Is Cataract??

 Occular opacity, partial or complete.

 Impairing Vision or causing blindness.
 Cloudy Appearance of the eye.
 Can affect one or both eye.
 On or in the “Lens” or “Capsular”.
 Development of Cataract

 Lens is made mostly of water and protein.

 Normally, protein is arrange to let light pass through
and focus on the retina.
 Cataract Formation

1. Early Stage - Change Prescription.

2. Late Stage – Surgical Removal.
 Type Of Cataract

1) Age relate cataract – Most related to “Aging factor.”

2) Congenital Cataract – Develop in “Childhood.”
3) Secondary Cataract – Develop in people have
certain health issue (Diabetis or Steroid use).
4) Traumatic Cataract – Cataract which develop after
an “Eye Injury.”
 Age factor

Aging
Factor
Congenital

Could Lead to
Blindness
Traumatic Cataract
Traumatic Cataract
 Cataract Investigation

Eye Examination :
1) Visual Acuity – Test to measure eye vision at various distances.
2) (Tonometri) - test measures the pressure inside your eye, which is
called intraocular pressure (IOP).
3) Visual Field Test.
4) Pupil Dilation – To see more of the len and look for another eye
problem.
5) Slit Lamp - examination of the anterior segment and posterior
segment of the human eye.
6) A-scan - Provides data on the length of the eye.
7) B-scan - accurately image intraocular structures and give valuable
information on the status of the lens
8) Keratometer - measuring the curvature of the anterior surface of
the cornea.
Visual Acuity
Tonometer
Pupil Dilation
Slit Lamp
Keratometer
 Treatment

Surgery:
 Intracapsular cataract extraction (ICCE):
 The entire cataractous lens along with the intact
capsule are remove in this procedure.
 Extracapsular cataract extraction (ECCE):
 Lens nucleus is extracted, and the cortical matter is
aspirated, leaving behind intact posterior capsule.
 Lensectomy:
 Most of the lens including anterior and posterior
capsule along with anterior vitreous are remove.
 Pre operative Management

Pre-Op evaluation :
(Hx Taking)
General health:
 DM, Ischemic heart diasease, HTN..etc
Occular History:
 Trauma, inflamation..etc
External Examination:
 Look for abnormalities of external eye, pupil
reaction.
Slit Lamp :
 Scar, conjuctivitis, penetrating..etc
Cornea:
 Corneal dsytrophy.
Anterior Chamber:
 Shallow or deep.
Iris:
 Pupil size after dilation.
Fundus:
 For DM patient, check for macular edema.
Visual Acuity Test:
IOL selection:
 Check biometry does belong to patient.
 Check for intraoccular consistensy in axial length.
 If axial length diference, comfirm by B-scan.
 Pre Operative medication

Topical antibiotic:
 Gemtamycin or ciprofloxacin QID.
 Eyelashes of upper lid should be trimmed before
surgery
Detail consent should be obtained.
 Post operative Management

Cornea:
 Wound Sealed.
Pupil:
 Round, regular and reacting.
PCIOL:
 Centre and in the bag.
Consider to:
 IOP Checking.
 Give clear instruction for post-operative drop.
 Use clear eye shield.
 What to expect (Discomfort).
 What to worry (Increasing Pain)
 Where to get help (Including phone number)
 Final review

2-4 week:
 Examination – Visual acuity.
 Cornea wound sealed (Seidel test – Negative)
IOP:
 Fundus – No cystoid mascular edema, flat retina.
6-8 week:
 Operation corneo scleral suture are remove.
 Final spectacle – prescribed after about 8 week of
operation.
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