A cataract is a clouding of the lens in the eye leading to adecrease in vision. It can affect one or both eyes. Often it develops slowly. Symptoms may include faded colours, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognising faces. Poor vision may also result in an increased risk of falling and depression. Cataracts are the cause of half of blindness and 33% of visual impairment worldwide.
AGE: Age is the most common cause. Lens proteins denature and degrade over time, and this process is accelerated by diseases such as diabetes mellitus and hypertension.
TRAUMA: Blunt trauma causes swelling, thickening, and whitening of the lens fibres. While the swelling normally changes with time, the white colour may remain. In severe injuries which penetrate the eye, the capsule is damaged.
RADIATION: Ultraviolet light, specifically UVB, has been shown to cause cataracts, and some evidence indicates sunglasses worn at an early age can slow its development in later life. Microwave radiation has also been found to cause cataracts. The mechanism is unclear, but it may include changes in heat-sensitive enzymes that normally protect cell proteins in the lens. Another possible mechanism is direct damage to the lens from pressure waves induced in the aqueous humour.
SKIN DISEASES: The skin and the lens have the same embryological origin and so can be affected by similar diseases. The people who haveatopic dermatitis and eczema develop ulcers cataracts. Ichthyosis is an autosomal recessive disorder associated with cuneiform cataracts and nuclear sclerosis. Basal-cell nevus and pemphigus have similarities.
MEDICATIONS: Medicines, such as inhaled corticosteroids, increases the risk of cataract development. People with diseases such asschizophrenia often have risk factors for lens opacities but antipsychotic medications are Unlikely to contribute to cataract formation.
Cataract can be removed at any stage and requires no ripening of the lens. Surgery is usually 'outpatient' and performed using local anesthesia. About 9 of 10 patients can achieve a corrected vision of 20/40 or better after surgery. Several evaluations found that cataract surgery can meet expectations only when significant functional impairment due to cataracts exists prior to surgery. Visual function estimates such as VF-14 have been found to give more realistic estimates than visual acuity testing alone.In some developed countries, a trend to overuse cataract surgery has been noted, which may lead to disappointing results.Phacoemulsification is the most widely used cataract surgery in the developed world. This procedure uses ultrasonic energy to emulsify the cataract lens. Phacoemulsification typically comprises six steps:
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