A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope (lens capsule), varying in degree

from slight to complete opacity and obstructing the passage of light. Early in the development of age-related cataract, the power of the lens may be increased, causing near-sightedness (myopia), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors.

Mild clouding of the lens often occurs after age 60, but it may not cause any vision problems. By age 75, most people have cataracts that affect their vision. Visual problems may include the following changes: Photophobia Cloudy, fuzzy, foggy, or filmy vision Difficulty seeing at night or in dim light

Double vision (monocular diplopia) Loss of color intensity Problems seeing shapes against a background or the difference between shades of colors Seeing halos around lights Red reflex seen with direct opthalmoscope is distorted or absent

Increasing age Drinking excessive amounts of alcohol Excessive exposure to ultraviolet light People who live in high altitudes or who works in bright sunlight

From systemic disorders (diabetes, tetany, myotonic dystrophy, neurodermatitis, galactosemia, Lowe syndrome, Werners syndrome and Downs syndrome) From intraocular disorders (iridocyclitis, retinitis, retinal detachment and onchocerciasis) From infections (german measles, mumps, hepatitis, poliomyelitis, chickenpox, infectious mononucleosis)

Blunt trauma Lacerations Foreign bodies Exposure to ionizing radiation, such as that used in X-rays and cancer radiation therapy Family history of cataracts High blood pressure Obesity Previous eye surgery Prolonged use of corticosteroid medications Smoking

History and PE Documentation of visual acuity Ask client to describe visual disturbances Assist client to gain or maintain as much independence as possible Evaluate clients lifestyle, abilities, and home environment

Postop Care:
The eye is covered with a dressing and eye shield to protect it from injury The patient is allowed out of bed the day following surgery Daily change of dressing. After 7 to 10 days, all dressings are usually removed During the first month, protect the eye with a shield at night Administer eye drops as ordered

There is no known treatment other than surgery that prevents or reduces cataract formation. But some research presented that egg yolks may improve vision. Preoperative eyedrops may include a dilating agent such as tropicamide (Mydriacyl) to facilitate surgery. A cycloplegic cyclopentolate (Cyclogyl) may be administered to paralyze ciliary muscles.

Intracapsular technique. Removal of cataract within its capsule. (ICCE) Extracapsular technique. An opening is made in the capsule and the lens is lifted without disturbing the membrane. An aphakic person is very farsighted (hyperopic) (ECCE) Cryoextraction, the cataract is lifted from the eye by a small probe that has been cooled to a temperature below zero and adheres to the wet surface of the cataract.

Iridectomy. Done preceeding cataract extraction to create an opening for the flow of the aqueous humor which may become blocked postop when the vitreous humor moves forward. This is to prevent secondary glaucoma. Phacoemulsion. A method of cataract removal which breaks up the lens and flushes it out in tiny pieces.

External eye examination reveals the following:

Conjunctiva thins and becomes yellowish White ring around iris (arcus senilis) does not affect vision Dry eyes due to decreased tear production Drooping eyelids (senile ptosis) Entropion and ectropion common in the older adult Clouding of lens (cataracts) Yellowish nodules on bulbar conjunctiva (pinguecula) common

Visual examination reveals the following:

Presbyopia (decreased near vision due to decreased elasticity of lens) common in clients older than 45 years Slowed pupillary response and slowed accommodation Poorer night vision and decreased tolerance to glare

Visual field examination reveals the following: Decreased peripheral vision Difficulty differentiating blues from greens Funduscopic examination reveals the following : Pale narrowed arterioles

The lens is made of mostly water and protein. The protein is arranged in a specific way that keeps the lens clear and allows light to pass through it to focus a clear image onto the retinal surface. As we age, some of the protein may clump together and start to cloud a small area of the lens. This is our understanding of the cause of an age-related cataract. Over time, the cataract may become more dense or cloud more of the lens, making it more difficult to see through. A cataract is not a growth or tumor.