Clouding of crystalline lens of eye Losing transparency of the lens of the eye Limits light entering in to the eye Gradual vision loss leads to complete blindness
Cornea Posterior A. chamber Nuclear Lens Anterior Retina Optic nerve
If Cataract is mature- white pupil in the room light Flash a torch- see white reflection Use an Ophthalmoscope at a distance- see disturbed red reflex Examine with a slit lamp Relate findings to person’s vision
Simple, quick procedure takes less than 10 minutes Extraction of lens with cataract Implantation of an artificial lens (IOL) • Conventional ECCE • Phaco-emulsification • Small incision cataract surgery
General fitness, willingness, awareness Exclusion of other disease Diabetes- urine ward test, FBS Hypertension- BP Ischaemic heart disease- ECG Cleanliness, clothing Biometry- A scan, Keratometry Pre-op medication Systemic- anxiolytic Topical- antibiotic, mydriatic Assessment of cataract- type, maturation To determine technique of surgery
Extracapsular cataract extraction 1. Anterior 2. Completion of capsulotomy incision 3. Expression of 4. Cortical cleanup nucleus 5. Care not to aspirate posterior capsule 6. Polishing of posterior accidentally capsule, if appropriate
Extracapsular cataract extraction ( cont. ) 8. Grasping of IOL and 7. Injection of coating with viscoelastic viscoelastic substance substance 9. Insertion of inferior 10. Insertion of superior haptic and optic haptic 11. Placement of haptics into capsular bag and not into ciliary 12. Dialling of IOL into sulcus horizontal position
Phacoemulsification 1. Capsulorrhexis 2. Hydrodissection 3. Sculpting of nucleus 4. Cracking of nucleus 6. Cortical cleanup and 5. Emulsification of insertion of IOL each quadrant
Patient can be sent or kept over night Examined on the following day Needs topical steroid / antibiotic cover Follow up in one week / one month Suture removal if necessary Refraction Provision of spectacles Discharge
Simple procedure Quick Less complications Easy post-op care Excellent visual outcome No long term follow up
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