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Monday, October 19, 2009

Cataract

Few years ago, i was asked to give a lecture about cataract and phacoemulsification- a procedure with the use of ultrasonic devise breaks and aspirates the cataract - in modern day eye surgery. A new service is being opened in the hospital which deals primarily on cataract surgery and i was appointed team leader. Part of my job is to conduct a refresher course on the anatomy and physiology of the eye and train the nursing staff to assist/ scrub in surgery.

image: wikipedia

Cataract is a result of opacification or cloudiness of the crystalline lens which affects one's vision. To say it is a condition that affects only the elderly is not entirely true. However, most cataracts are related to aging - like everything else in our body - our lenses undergoes a wear and tear process as we grow old.

Symptoms are blurry vision, glare, poor night vision and double vision. Since cataract develops gradually, treatment varies from wearing eye glasses or using a magnifying glass , improved lighting and surgery.

There are different types of cataracts which can be a result of different health /eye condition. Some of which are:

Secondary cataract - is a secondary result of another eye problem or condition such as glaucoma. It could be a result of another health issue such as diabetis. There's a prevailing view that steroid used can induce cataract.

Acquired cataract / radiation cataract - can result after overtime exposure to any types of radiation for a period of time.

Congenital cataract - unfortunately, some babies are born with cataract but this condition is quiet rare.

Traumatic cataract - a result of trauma to the eye itself which can manifest years later. This kind of cataract affects people below 40 years of age.

A surgery to correct this condition is known as "Cataract Extraction with Intra-Ocular Lens Implantation". This is done to remove the lens and replace it with synthetic ones. Owing to continuous evolution of surgical techniques and equipment in surgery, the modern procedure is now called Phacoemulsification . The cataract is emulsified with an ultrasonic device through a microscopic incision instead of the conventional method of making a big incision to remove the opaque lens and closed the wound with few stitches. The lenses being implanted is another breakthrough- a foldable lens to be inserted into an almost needle size incision.

The advantage of this modern technique is that the patient can go home after an hour and resume activities of daily living in a day or two- though one needs to observed moderation for at least a week. Owing to a very small incision - between 2.25 to 2.75mm- the chances of infection is greatly reduced, there's limited manipulation of the eye and no eye irritation due to stitches.



note: some people finds this video disturbing. watch at your own risk.


this article does not intend to diagnose. it is to share useful information of author's experiences as an operating room nurse/perioperative nurse

20 comments:

  1. very good info. but how about it post surgery complication?

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  2. thanks for sharing these..uh i love it here so informative and love to read and see all posts here!

    To chay..thanks for the comments and to other members of salitype! Godbless you all!

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  3. thanks for sharing this,Eng! surely there will be friends who will find this useful. :)

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  4. This is really good information.

    Some cataract surgery may affect ones whole life. My cousin told my family a friend of his who had cataract underwent cataract treatment ended up becoming blind on one eye...

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  5. Thanks for the knowledge sharing. For us who keep staring at the computer screen, I do not know high is the risk to develop cataract.

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  6. Hi Eng, Interesting education about cataracts. Both George and I went for our yearly eye check-ups recently. My eyes are fine---other than needing reading glasses (which I buy from someplace like Walmart).

    George has had the beginning of a cataract for several years--but it hasn't gotten worse. The doctor said that it may never develop into a real cataract.

    Thanks again for the education.
    Hugs,
    Betsy

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  7. Hi Eng ! For a nursing student like me, these informations mean a lot - I love it !

    I read about this a couple weeks ago when we were studying A&P, and I was really amazed when I learned about the "Cataract Extraction with Intra-Ocular Lens Implantation". I thought that was amazing.

    Hats off to you girlfriend, you are awesome !

    More of these kind of stuff Eng - I really enjoy the information !

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  8. jay...

    thanks for dropping by.

    post operative complication of this kind of surgery is not totally unheard of but quite low.it is one of the most successful surgery being carried away.

    sight treatening complications are very rare - endopthalmitis and retinal detachement.

    minor complications such as temporary cloudiness of the cornea, infection, and raised eye pressure occurs BUT does not affect the final result - opbtaining normal vision.

    eng

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  9. rainfield....

    as far as i know...staring in the computer screen has no bearing on having cataract. but it is not good for your eye to stare in the monitor for longer hours as it makes your eyes tired, makes one blinks less that causes dryness of the cornea.

    thanks, rain!

    eng

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  10. Interesting post here Eng, wish to be one of your audience. :) this time it won't be about photos or the captions, it's career. :) A nice week ahead.

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  11. This is very useful information! I do have this case as I'm growing older..

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  12. I'm glad cataracts can be corrected with surgery as they are not uncommon especially in older people. The video is fascinating!

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  13. eng, for the past couple of years now, i have been busy reading about eye conditions and treatment procedures- such as this one you shared with us. the reason is, my dad has two incurable eye conditions- retinitis pigmentosa and macular degeneration:( if only he had cataracts instead ... at least he could undergo surgery to remove them. sadly, there's no cure yet for what he has, and his eyesight is dwindling by the day:( i could tell when i last vacationed in the phils in 2006 .. the way he stumbled around and bumped into things:( so sad. pls. pray for my dad. and if you hear of any sure cure for what he has, pls let me know immediately. i know there are a number of experimental treatments, to slow the loss of sight .. and a bunch of ocular drugs/vitamins (i send occuvite to him every few months). but i'm hoping, praying for a cure .. something to give me hope, to give my family hope that my dad can see clearly again someday. thank you for sharing this educational post, eng.

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  14. very educational! too bad I can't take to watch the vid =P

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  15. Cataracts are wild. My dad had them but 1 hour of surgery later and they're all gone. Amazing.

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  16. A very informative post, Eng. One of my fears is loosing my eyesight, that's why I am so cautious, and do preventive measures of eye care. I am near sighted, so no glasses reading your post!

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  17. mj, girl!

    there's a new surgical rehabilitation procedure for macular degeneration, called IOL- VIP.This procedure is fairly new which as everything else that just comes out on the market, very costly. very few opthalmologist can perform such procedure and the lenses being implanted can cost a fortune.

    there are two intra-ocular lenses being implanted, one on top of the other, to create a Galelian telescope within the eye.the procedure can be done under local anesthesia. it may take a week or so before one can adjust seeing thru the new lenses.

    eng

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  18. my niece has this Eng and she had this when she was still young until now, we are afraid that she will loose her sight.

    thank you for this Eng really informative.

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  19. Some old folks keep going untreated. The first time I saw them I though the old folk is caucassian :D

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  20. This was very interesting. Most people only go to the optometrist when they need glasses. Even if you don't have glasses you should get your eyes checked every so often.

    Both my children have a squint. Originally my daughters turn was about 20 degrees, an operation corrected this but over time it has come back to about 10 degree. My son also has about a 10 degree turn neither wears glasses or patches as they alternate eyes.

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