II. Epidemiology
- Most common cause of severe Visual Impairment in U.S.
- Present in 70% of patients older than 70 years old
III. Pathophysiology
- Opacification of the crystalline lens of the eye
- Stages of development
- Immature Cataract
- Opacities separated by areas of clear lens
- Mature Cataract
- Complete lens opacification
- Hypermature Cataract
- Lens cortex is liquefied
- Lens capsule looses fluid
- Risk of Inflammatory reaction
- Risk of secondary Glaucoma
- Immature Cataract
IV. Locations
- Nuclear Cataracts
- Central lens (nucleus) becomes dense and sclerotic
- Discolored by yellow, brown or gray hue
- Cortical Cataracts
- Peripheral opacities
- Radiating spokes appearance on Slit Lamp exam
- Posterior Subcapsular Cataracts
- Most rapidly progressive
- Seen in younger patients and those on Corticosteroid
V. Risk factors
- Normal Aging (90% of cases)
- Tobacco Abuse
- Ocular UV-B light exposure
- Traumatic Injury to lens or capsule
- Comorbid conditions
- Medication related
- Systemic Corticosteroid
- Topical EchothiophateIodide (Glaucoma treatment)
VI. Symptoms
- Progressive reduced Vision (usually bilateral)
- Patients report Clouding or fogging of Vision
- Nuclear Cataracts may improve site temporarily
- Cataract sclerosis changes shape of Lens nucleus
- Myopia may result and may correct Farsightedness
- Skewed Color Perception
- Lens becomes pigmented in nuclear sclerotic Cataracts
- Blues filtered out
- Color is shifted to yellow and red part of spectrum
- Diminished Vision in bright light
- Central opacities block light when pupil constricts
- Glare may also occur
- Reduced night Vision (with halos in Visual Fields)
VII. Signs
- Lenticular opacities of various shapes and degree
- Technique
- Set ophthalmoscope to +10
- View lens from 12 inches from patient's face
- Cataracts appear as dark areas against red pupil
- Red Reflex overall appears dull
- Consider dilating pupil for exam
- Phenylephrine hydrochloride Ophthalmic Solution
- Not Cycloplegic
- Does not affect close Vision
- Phenylephrine hydrochloride Ophthalmic Solution
VIII. Management
- Assessment of concurrent eye disorder
- Glaucoma
- Retinal Detachment
- Macular Degeneration
- Retinal vascular occlusive disease
- Retinopathy of Diabetes
- Hypertension
- Arteriosclerosis
- Maximize Refractive Error correction with glasses
- Consider dilating drops to improve Vision
- Ophthalmology referral for Cataract Extraction
- Procedure
- Phacoemulsification with intraocular lens replacement
- Indications (Refer for impaired function or refractory symptoms)
- References
- Procedure
IX. Prevention
- Avoid excessive UV Light exposure
- Smoking Cessation
X. References
Images: Related links to external sites (from Bing)
Related Studies
| Concepts | Acquired Abnormality (T020) |
| ICD9 | 366.10, 366.1 |
| ICD10 | H25 , H25.9 |
| SnomedCT | 155127007, 193583005, 193582000, 193594009, 39450006 |
| English | Senile cataract, unspecified, Unspecified senile cataract, senile cataract, senile cataract (diagnosis), Senile cataract NOS, cataract senile, Cataract;senile, age related cataracts, age-related cataract, cataracts senile, Age-related cataract (disorder), Senile cataract NOS (disorder), Unspecified senile cataract (disorder), Senile cataract, Age-related cataract, Senile cataract (disorder), Senile cataract, NOS, Age-related cataract [Ambiguous], Senile Cataract |
| Dutch | seniel cataract, seniel cataract, niet-gespecificeerd, Seniel cataract, niet gespecificeerd, Seniel cataract |
| French | Cataracte sénile, Cataracte sénile, non précisée |
| German | seniler Katarakt, seniler Katarakt, unspezifisch, Cataracta senilis, Senile Katarakt, nicht naeher bezeichnet |
| Italian | Cataratta senile, Cataratta senile, non specificata |
| Portuguese | Catarata senil NE, Catarata senil |
| Spanish | Catarata senil, Catarata senil no especificada, catarata senil no especificada, catarata senil, SAI (trastorno), catarata senil, SAI, catarata senil no especificada (trastorno), catarata senil (trastorno), catarata senil |
| Japanese | 老人性白内障, 老年性白内障、詳細不明, ﾛｳﾈﾝｾｲﾊｸﾅｲｼｮｳｼｮｳｻｲﾌﾒｲ, ﾛｳｼﾞﾝｾｲﾊｸﾅｲｼｮｳ |
| Czech | Senilní katarakta, Nespecifikovaná senilní katarakta |
| Korean | 상세불명의 노년 백내장, 노년 백내장 |
| Hungarian | Időskori szürkehályog, nem meghatározott, Időskori szürkehályog |
Ontology: Cataract (C0086543)
| Definition (MEDLINEPLUS) |
A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery. A cataract can occur in either or both eyes. It cannot spread from one eye to the other. Common symptoms are
Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts. NIH: National Eye Institute |
| Definition (MSHCZE) | Onemocnění čočky oka, při němž dochází ke ztrátě její průzračnosti s postupným zhoršováním zraku. K. se dělí podle různých kritérií. Podle vývoje je k. stacionární (obv. vrozená) nebo progresivní. Podle doby vzniku může být k. vrozená či vznikající v mládí (juvenilní) či ve stáří (senilní). Další dělení je podle oblasti čočky, která je postižena (u senilních katarakt oblast kortikální či nukleární, u vrozených mohou být zákaly postihující celou čočku, či jen některé oblasti, zejm. pouzdra), podle stupně vývoje zákalu (nezralá, zralá, přezrálá k.), podle příčin. K příčinám patří poškození během vývoje plodu (toxicky, infekčně, např. rubeola), vrozené syndromy či metabolické poruchy (galaktosemie), onemocnění či traumata oka (zejm. recidivující, např. uveitidy, glaukom, amotio retinae, silná myopie), celková onemocnění (zejm. diabetes, dále např. kožní choroby, tetanus), působení zevních fyzikálních faktorů (ionizační záření, infračervené záření, sideróza, chalkóza). Obecným příznakem je zhoršení zraku, který však může zůstávat neporušen u některých vrozených a neprogredujících katarakt. Léčbou k. narušující zrak je ve vhodné době provedená extrakce oční čočky s její náhradou (brýle, kontaktní či intraokulární čočka). (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (NCI_CTCAE) | A disorder characterized by partial or complete opacity of the crystalline lens of one or both eyes. This results in a decrease in visual acuity and eventual blindness if untreated. |
| Definition (NCI_NCI-GLOSS) | A condition in which the lens of the eye becomes cloudy. Symptoms include blurred, cloudy, or double vision; sensitivity to light; and difficulty seeing at night. Without treatment, cataracts can cause blindness. There are many different types and causes of cataracts. They may occur in people of all ages, but are most common in the elderly. |
| Definition (NCI) | Partial or complete opacity of the crystalline lens of one or both eyes that decreases visual acuity and eventually results in blindness. Some cataracts appear in infancy or in childhood, but most develop in older individuals. (Sternberg Diagnostic Surgical Pathology, 3rd ed.) |
| Definition (MSH) | Partial or complete opacity on or in the lens or capsule of one or both eyes, impairing vision or causing blindness. The many kinds of cataract are classified by their morphology (size, shape, location) or etiology (cause and time of occurrence). (Dorland, 27th ed) |
| Definition (CSP) | opacity or cloudiness of the crystalline lens, which may prevent a clear image from forming on the retina; may be congenital or caused by trauma, disease, or age. |
| Concepts | Anatomical Abnormality (T190) |
| MSH | D002386 |
| ICD9 | 366.9, 366 |
| ICD10 | H26.9 |
| SnomedCT | 193570009, 128306009, 155130000, 193623003, 155126003, 62795009, 247053007 |
| LNC | LP128693-1, MTHU020817, MTHU040525 |
| English | Cataracts, Unspecified cataract, Cataract NOS, Cataract, unspecified, Cat. - Cataract, cataract, Cataract (M-54510), cataract (diagnosis), Cataract unspecified, Cataract [Disease/Finding], lens opacity, lenticular opacity, cataracts, Cataract NOS (disorder), CATARACT, Cataract form, Cataract (disorder), Cataract (morphologic abnormality), Cataract form (observable entity), cataract; eye disease, eye disease; cataract, Cataract, NOS, Cataract (disorder) [Ambiguous], Cataract |
| French | CATARACTE, Cataracte non précisée, Cataracte SAI, Cataractes, Cataracte |
| Portuguese | CATARATA, Catarata NE, Pseudoafaquia, Cataratas, Catarata |
| Spanish | CATARATA, Catarata no especificada, Cataratas, Catarata NEOM, catarata, SAI (trastorno), catarata, SAI, Cataract NOS, catarata (anomalía morfológica), catarata (concepto no activo), catarata (trastorno), catarata, forma de la catarata (entidad observable), forma de la catarata, Catarata |
| German | KATARAKT, Katarakt NNB, unspezifischer Katarakt, Katarakt unspezifisch, Katarakte, Katarakt, nicht naeher bezeichnet, Katarakt, Star, grauer |
| Dutch | niet-gespecificeerd cataract, cataract NAO, cataracten, cataract niet-gespecificeerd, cataract; oogziekte, oogziekte; cataract, Cataract, niet gespecificeerd, cataract, Cataract |
| Italian | Cataratte, Cataratta non specificata, Cataratta NAS, Cataratta |
| Japanese | 白内障ＮＯＳ, 詳細不明の白内障, ﾊｸﾅｲｼｮｳNOS, ｼｮｳｻｲﾌﾒｲﾉﾊｸﾅｲｼｮｳ, ﾊｸﾅｲｼｮｳ, 水晶体混濁, 白そこひ, 白内障 |
| Swedish | Grå starr |
| Czech | šedý zákal oční čočky, katarakta, Katarakta, Nespecifikovaná katarakta, Katarakta NOS, Katarakty, cataracta, šedý zákal |
| Finnish | Kaihi |
| Russian | KATARAKTA, KHRUSTALIKA POMUTNENIE, PSEVDOAFAKIIA, КАТАРАКТА, ПСЕВДОАФАКИЯ, ХРУСТАЛИКА ПОМУТНЕНИЕ |
| Korean | 상세불명의 백내장 |
| Croatian | KATARAKTA |
| Polish | Zaćma, Zmętnienie soczewki |
| Hungarian | Szürkehályog k.m.n., Cataracták, Szürkehályog, Nem meghatározott szürkehályog |
| Norwegian | Grå stær, Katarakt |
