Cataracts

Opacifications within the lens

Aetiology

  • Many different causes, often age-related
  • Many different types
  • 50% of all causes of blindness worldwide

Risk factors

  • Cumulative UVB damage increases likelihood of cataracts; there is an alteration in reparative mechanisms with age
  • Hypertension
  • Smoking
  • Post operative and trauma
  • Steroids
  • Metabolic disorders e.g. diabetes - changes to osmotic pressures and altering of fluid content in lens damages epithelial cells and fibres
  • Genetic

Pathophysiology

  • Epithelium of the lens matures with time and eventually the cell contents are replaced and the nucleus disappears
  • The cell outline is left and becomes a fibre within the lens
  • In cataracts there is degenerative change of the fibres resulting in opacifications

Clinical presentation

  • Gradual visual loss ('hazy'/'blurred')

Management

  • Surgical removal with intra-ocular lens implant if patient is symptomatic