Cataract - Causes, Symptoms and Treatment .MF .
Cataracts - clouding of the lens, covering it partially or completely.Sometimes congenital and acquired.
Causes of cataract
acquired cataracts are age, complications (associated with eye disease), caused by common diseases, toxic (the action of some drugs) and traumatic arising from the action of physical, chemical or thermal and radiation factors.
with age (usually after age 50), the lens fibers are compacted and its possible clouding.Also, to lead the development of cataract eye disease such as relapsing iridocyclitis, chorioretinitis, glaucoma, retinal degeneration, high myopia.In all these states, there are degenerative changes in the lens.
Quite a lot of common diseases lead to the development of cataracts.For example, diabetes, emaciation due to starvation, infectious diseases (malaria, typhoid).The toxic effect of the lens have hormones.
Traumatic cataracts can occur with blunt and penetrating wounds of the eye.Very often, there is a so-called ring Fossiusa (pigment print iris rings, which
the lens is capable of absorbing the invisible infrared rays, cataracts may develop radiation workers of hot shops, and the irradiation of the orbit without the use of protective equipment (goggles, mask).
Congenital cataracts are associated with impaired differentiation of the lens during embryogenesis and are not amenable to conservative treatment.
cataract Depending on localization distinguish cataract:
- polar (front and rear) - are located at the front or rear pole
- spindle - are located on the anterior-posterior axis in the center of the lens
- layered -
around the nucleus - cortical (under the capsule oval)
- nuclear - are taking a core
- full - clouding of the lens in all
by the degree of development of the isolated stage cataract: primary, immature, mature and overripe.
an initial changes begin at the periphery, decreased vision is absent or insignificant.Amenable to conservative treatment.
When immature turbidity increases and decreases vision.Perhaps the development of cataracts swelling, which leads to complications (fakogennaya glaucoma).
Mature characterized seal the opaque lenticular masses and persistent decrease in visual acuity.It requires surgical treatment.
overripe cataracts (dairy, morganieva) is rare.This breaks the cortical substance, dense core is separated from the capsule and "settles" on her bottom.It may be complicated by glaucoma (because there is inflammation) and iridocyclitis to break the lens capsule and the output of the masses in the anterior and posterior chamber of the eye.Treatment only operative.
symptoms, in which you can suspect cataract and seek medical advice:
- reduced visual acuity up to light perception.If clouding occupies the central part, the patient sees better in the evening, when the pupil expands and the unaffected area of the lens is increased;
- lens may acquire gray.
When the above symptoms should consult a doctor for further diagnosis.
- visual acuity (from normal to light perception and blindness).In normal retinal light perception with the correct projection.Otherwise, surgery will not return the eye, but can save the eye as an organ.
- perimetry for determining the condition of the retina and diagnosis of possible complications;
- determination of intraocular pressure for glaucoma exceptions.If necessary tonography;
- research in transmitted light.When a cataract on the background of pink reflex fundus determined by the shade of a muddy lens;
- biomicroscopy to determine the location and degree of opacity;
- fundus examination to exclude comorbidities.
On the basis of these studies, the doctor can make a diagnosis, but to determine the cause, additional methods and advice:
- General clinical tests, including blood sugar;
- physician consultation, ENT, dentist to rule out concomitant pathology and identify contraindications for surgical treatment (active inflammation, severe decompensated disease).
Treatment should be initiated in a timely manner, it can be conservative and surgical.
Conservative treatments include the appointment of drops that improve metabolism (metabolism) of the lens, to slow the progression of opacities.These include Taufon, Kvinaks, Oftan-Katahrom.1-2 drops instilled in the conjunctival sac 3 times a day continuously.Breaks in treatment contribute to disease progression.
increasingly used surgical treatment of cataracts.With the development of medicine do not even need to go to hospital.Some operations are performed without cuts, out-patient, and the patient on the same day goes home.
methods of surgical treatment of cataract:
- intracapsular cataract extraction - historical method is not used due to high trauma and complications.At the same time the lens is removed completely from the capsule;
- extracapsular cataract extraction - removal of darkened masses while maintaining the capsule and its replacement intraocular lenses (IOLs), which performs all the functions of the lens.IOLs are rigid and flexible.It's almost always use the latest.
One of the most common treatments - cataract phacoemulsification with IOL implantation.Use a micro-incision, lenticular masses removed using ultrasound and implanted IOL.The entire procedure takes about 10 minutes.Local Anesthesia, which reduces the risk of complications.Patients prescribed drops, and he was sent home under the supervision of an ophthalmologist in the community.
- antibacterial drops (Floksal, Tobrex, Oftakviks) initially every hour, then 4 times a day for 10 days,
- anti-inflammatory drops (Indokollir, Diklof) 2 times a day, 2 weeks,
- hormonal drops (Oftan-dexamethasone Maksideks) every 12 hours for 2 weeks,
- when dry eye tears appoint substitutes (artificial tears, Sisteyn, Oksial) - drip as needed.
After the surgery is contraindicated weight lifting, being in dusty environments and outdoors in windy conditions, hypothermia, taking baths.
There are traditional methods of treatment, such as instillation into the eyes of diluted honey, Oral infusion of marigold, sage and others., But their effectiveness has not been proven, and some substances can harm.
Complications of cataract
event of failure or self-treatment may occur complications:
- total blindness
- fakogennaya glaucoma
- fakolitichesky iridotsyklit
- lens luxation
Cataract - the main cause of blindness, but when time begun treatment is almost always possible to restore vision.
Ophthalmologist Letyuk TZ