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Cataract
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ICD-9 366

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For the band with this name, see Cataract (band).

For the geographical feature, see Types of waterfalls.

Human eye cross-sectional view. Courtesy NIH National Eye Institute Normal vision. Courtesy NIH National Eye Institute The same view with a cataract.

In ophthalmology, a cataract is any opacity which develops in the crystalline lens of the eye or in its envelope. The name derives from the Latin cataracta meaning "waterfall" and the Greek kataraktes and katarrhaktes, from katarassein meaning "to dash down" (kata-, "down"; arassein, "to strike, dash") [1].

Cataracts form for a variety of reasons, including long-term ultraviolet exposure, secondary effects of diseases such as diabetes, or simply due to advanced age; they are usually a result of denaturation of lens proteins. Genetic factors are often a cause of congenital cataracts and may also play a role in predisposing someone to cataracts. Some cataract formation is to be expected in any person over the age of 70. Fully half of all people between the ages of 65 and 74 and about 70% of those over 75 have some cataract formation. Cataracts may also be produced by eye injury or physical trauma. A study among Icelandair pilots showed commercial airline pilots as three times as likely to develop cataracts as people with non-flying jobs. This is thought to be caused by radiation coming from outer space.

Cataracts may be partial or complete, stationary or progressive, hard or soft.

1 Cataract surgery
2 Etymology
3 Types of cataracts
4 Associations with systemic conditions
5 References
6 See also
7 External links

Cataract surgery

Main article: Cataract surgery

An early technique to remove cataracts was couching, which involved using a thin needle or stick to remove the clouding. This technique is known to have existed in Roman times and continued to be used throughout the Middle Ages and continues to be used in underprivileged "Third world" countries today. In India, however, modern surgery with intraocular lens insertion in Government and Non Government Organisation (NGO) sponsored Eye Surgical Camps have totally replaced this method.

The most effective and common treatment is cataract surgery to remove the cloudy lens. There are two types of surgery that can be used to remove cataracts, extra-capsular and intra-capsular surgery. Extra-capsular surgery consists of removing the lens but leaving the majority of the lens capsule intact. High frequency sound waves (phacoemulsification) are sometimes used to break up the lens before extraction. Intra-capsular surgery involves removing the entire lens of the eye, including the lens capsule, but it is rarely performed in modern practice. In either extra-capsular surgery or intra-capsular surgery, the lens is replaced with a plastic lens (an intraocular lens implant) which remains permanently in the eye.

Previously, polymethylmethacrylate was used as the lens material. Advances have brought about the use of silicone acrylate which is a soft material. This allows the lens to be folded and inserted into the eye through a smaller incision. Acrylic lenses can also be used with small incisions and are a better choice in people who have a history of uveitis or are at high risk of retinal detachment. Acrylic is not always an ideal choice due to its added expense.

Cataract operations are mostly performed under a local anaesthetic and the patient will be allowed to go home the same day. Complications after cataract surgery are common. Many people (up to 50%) can develop a posterior capsular opacification after initial cataract surgery. This is a thickening and clouding of the lens capsule (which was left behind when the cataract was removed) and it can be easily corrected using a laser to make holes in the capsule for the person to see through. Retinal detachment is an uncommon complication of cataract surgery.

Etymology

A cataract is a large waterfall or place where the flow of a river changes dramatically. The term comes from the Greek word kataraktes, whose meaning "to dash down" or "downrush" describes rapidly running water, and the Latin cataracta, whose meaning describes "a waterfall", "a floodgate", or "a portcullis". As rapidly running water turns white, the term was later used metaphorically to describe the similar appearance of mature ocular opacities.

Types of cataracts

Classified by etiology

Age-related cataract
Congenital cataract
Secondary cataract
Traumatic cataract

Classified by location

Anterior cortical cataract
Anterior polar cataract
Anterior subcapsular cataract
Nuclear cataract
Posterior cortical cataract
Posterior polar cataract
Posterior subcapsular cataract

Associations with systemic conditions

Chromosomal disorders

Alport's syndrome
Cri-du-chat syndrome
Conradi's syndrome
Myotonia dystrophica
Patau's syndrome
Schmid-Fraccaro syndrome
Trisomy 18 (Edward's syndrome)
Turner's syndrome

Disease of the skin and mucous membranes

Atopic dermatitis
Basal-cell nevus syndrome
Ichthyosis
Pemphigus

Metabolic and nutrition diseases

Aminoaciduria (Lowe's syndrome)
Diabetes mellitus
Fabry's disease
Galactosemia
Homocystinuria
Hypervitaminosis D
Hyperparathryroidism
Hypothyroidism
Mucopolysaccharidoses
Wilson's disease

Infectious diseases

Congenital

Congential herpes simplex
Congenital syphilis
Cytomegalic inclusion disease
Rubella

Others

Cysticercosis
Leprosy
Onchocerciasis
Toxoplasmosis

Toxic substances introduced systemically

Corticosteroids
Haloperidol
Miotics
Triparanol

References

Pavan-Langston, Deborah (1990). Manual of Ocular Diagnosis and Therapy. Little, Brown and Company.

External links

NHS Best Treatments Site
eMedicine Health
VisionSimulations.com | Images and vision simulators of various diseases and conditions of the eye
CureBlindness.org | Non-profit organisation performing cataract surgery in the Himalayas. Restore vision for less than $20.

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This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "cataract".