Cataracts

Topics: Ophthalmology, Cataract, Cataract surgery Pages: 7 (2340 words) Published: November 15, 2013
Cataracts
Subject: Solutions to the problem of Cataracts.

Cataracts is a condition that affects the eye due to an opacity of the internal focusing lens that can cause visual impairment due to light not being able to reach the retina. It is due to irreversible structural changes to the order of the fibres that the lens is made from due to coagulation and denaturing of the lens fibres. [9] It affects image clarity and causes a decline in image detail. However it almost never causes complete blindness. It can be caused by various different factors, the most prevalent being age. (90% of people over 75 have cataracts [8] and all over those over 80 are affected by it [9]). It is rare for young children to develop cataracts but in such cases it is usually down to hereditary factors, metabolic disorders and infections to the foetus during pregnancy. It is not life threatening for adults however for children it is much more dangerous as eyesight could not recover because it hinders the brains ability to interpret visual signs. [10]. However diabetes, high myopia, use of cortic steroids, renal failure, eye trauma, eye trauma, smoking, high alcohol intake, diet and exposure to UV rays all increases the chance of cataracts.

Phacoemulsification

The most popular and modern method used to treat the problem is Phacoemulsification. Its popularity stems from the fact that it takes no longer than 20 minutes, requires no sutures and only needs small incisions, meaning that recovery time is brief. It undergoes five steps; a Corneal incision, capsulorhexis, phacoemulsification, irrigation and aspiration.

The surgery would begin with the patient receiving an oxygen tube to breathe through as it would be difficult to do so through all of the precautionary draping. Blood pressure and heart rate would also be measured. The area behind the eyeball would be anaesthetized prior to any incisions made. Pressure is put on the eyeball to check if there is any and stop bleeding that could have been caused by the needle during the insertion of anaesthetic. It also decreases intraocular pressure, meaning complications are less likely. As the area undergoing the surgery is so small the whole procedure is viewed by the surgeon through a microscope to increase precision. A corneal incision of approximately 3mm is made on the anaesthetized side of the cornea; however the site may differ depending on the size and denseness of the cataract. A viscoelastic fluid is injected to reduce shock to intraocular tissues (using?). Another incision is then made on the membrane that surrounds the cataract. This is capsulorhexis. The cataract is separated from the cortex by a water stream. A titanium phaco tip is inserted into the cornea. Ultrasound waves emulsify the cataract starting at the densest area of the cataract, the central nucleus. The cataract is simultaneously aspirated from the eye through a small hole in the tip of the phaco probe. The cortex of the lens is removed however the posterior capsule is left to support the intraocular lens. Foldable IOL is used in phacoemulsification surgeries to minimise incision size, which decreases recovery time. This is inserted by an injector. After it is inserted into the capsular bag the viscoelastic fluid is removed. No sutures are usually required after surgery. [1]

Extra Capsular Extraction (ECE)

However an alternative method for treating cataract is extra capsular extraction. It is a microscopic surgery to completely remove the cataract. Prior to the procedure drops are used to dilate the pupil widely so most of the front surface of the lens is exposed. An incision is made around the upper edge of the cornea the surgeon will inject a small amount of helanoid (a clear gel) into the eye to maintain a space between the back of the cornea and the lens. A large part from the centre of the font capsule of the lens is removed and the hard nucleus squeezed out of the eye. The soft remaining parts of the lens...


Bibliography: [8]Gordon Macpherson, GM. (1999) blacks medical dictionary 39th edition. Madison Books.
[9] Dr Robert Youngson, RY. (2000) The Royal Society of Medicine Health Encyclopedia. Bloomsbury Publishing Ltd.
[10] Dr Havey Marcovitch, HM (2011) Blacks student Medical Dictionary. A & C Black Publishers Lt.
[13]Surgery Encyclopedia (publish date: unknown) http://www.surgeryencyclopedia.com/Ce-Fi/Extracapsular-Cataract-Extraction.html Last viewed (27/02/13)
[14]Dartry, D (2002) Cataract surgery
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