Pathophysiology - Cataract

CATARACTS – opacity of the eye’s normally clear, transparent crystalline lens

Causes

• Aging process
• Inherited
• Injury
• Endocrine disorders

Sign and Symptoms

• Gradual, painless blurring or loss of vision
• Photophobia
• Opaque or cloudy white pupil
• Decreasing visual acuity
• Progressive nearsightedness

Diagnostic Study

• Snellen visual acuity test – used to asses for vision
• Opthalmoscopy– examination of the fundus or interior of the eye
• Slit lamp examination – examination of the structures and fluid in the anterior segment of the eye using binocular microscope that magnifies the surface of the eye

Surgical management

• Intracapsular cataract extraction (ICCE)
• Extracapsular cataract extraction (ECCE)
• Phacoemulsification

Lens Replacement

• Aphakic eyeglasses
• Contact lenses
• Hard lens
• Gas-permeable hard lens
• Soft lens
• Intraocular lens implant

Pharmacologic treatment

• Mydriatrics – pupil dilator
• Epinephrine, adrenaline, phenylephrine HCL
• Cycloplegics – pupil dilator and paralysis of ciliary body
• Atropine SO4, scopolamine hydrobromide, cyclopentolate
• Acetazolamide, mannitol
• Antibiotics
• Mild analgesics

Nursing Management

• Pre-op
• Assess vision on unaffected eye
• Administer pre-op medications
• Instruct post-op measures to prevent changes in intra ocular pressure
• Post-op
• Semi-fowler’s position
• Prevent increase intra ocular pressure
• Keep a patch or protective shield on affected eye
• Relieve post-op discomfort
• Keep things on non-operative side