Cataract

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Summary of Cataract

A cataract is a clouding of the lens in the eye leading to a decrease in vision. It can affect one or both eyes. Often it develops slowly. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. This may result in trouble driving, reading, or recognizing 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.

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Cataract

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OTHER DIAGNOSTICS ▪ Clinical presentation: history; ↓ visual acuity, visual ﬁelds (central vision loss) TREATMENT MEDICATIONS ▪ Exudative ARMD ▫ Intravitreal injections of VEGF antagonists to reduce neovascularization ▫ Alternative: photodynamic therapy; injection of photosensitive dye verteporﬁn → damages neovascular endothelium; application of photoactivating laser Figure 77.1 Drusen in the macula of individual with age-related macular degeneration. OTHER INTERVENTIONS ▪ No curative method; therapy aimed at slowing progression ▪ Vitamin, antioxidant supplements ▪ Nonexudative ARMD ▫ Smoking cessation CATARACT osms.it/cataract PATHOLOGY & CAUSES ▪ Painless, gradual decline in vision due to opaciﬁcation of lens ▪ Proteins deposit on lens → reduce transmission of light to retina → decrease in vision ▪ Often bilateral but asymmetrical; congenital/ acquired TYPES Nuclear ▪ Opaciﬁcation of lens nucleus ▪ Slow progression of vision loss Cortical ▪ Opaciﬁcation of lens ﬁbers surrounding 600 OSMOSIS.ORG nucleus (cortex) ▪ Mild degradation of vision Posterior subcapsular ▪ Opaciﬁcation in posterior cortical layer under lens capsule ▪ Rapid progression RISK FACTORS ▪ Age-related cataract; usually > 60 ▪ Smoking, excessive alcohol use, prolonged drug use (esp. glucocorticoids), exposure to UV light, eye trauma/infections, radiation of intraocular tumor, trisomies (13, 18, 21) ▪ Metabolic diseases: diabetes mellitus, Wilson disease, galactosemia, myotonic dystrophy

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Cataract

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is the most common type of cataract, involving the central part of the lens.

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A 2-year-old girl comes to the office for a well-child visit. Physical examination shows the finding seen below. She is referred to an ophthalmologist who performs a dilated fundoscopic examination and ocular ultrasound and rules out malignancy. Which of the following is the most likely cause of this patient's abnormal finding?

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