Cataract - Causes, symptoms and treatment. MF.

Cataract - the turbidity of the lens, covering it partially or completely. Happens congenital and got.

Causes of cataract

Acquired cataracts are age-related, complicated( associated with eye diseases), caused by common diseases, toxic( some drugs) and traumatic, arising from the effects of physical, chemical or thermal and radiation factors.

With age( more often after 50 years), the lens fibers are densified and possibly clouded. Also, cataracts are caused by eye diseases such as recurrent iridocyclitis, chorioretinitis, glaucoma, retinal degeneration, high degree myopia. With all these states, degenerative changes occur in the lens.

A lot of common diseases lead to the development of cataracts. For example, diabetes, starvation, infectious diseases( malaria, typhus).Toxic effect on the lens is provided by hormonal preparations.

Traumatic cataracts can occur with blunt and penetrating wounds of the eye. Very often there is a so-called Fossius ring( an imprint of the pigmentary iris ring, which, with adequate treatment, resolves).With the development of true cataracts, vision is steadily declining.

the lens is capable of absorbing invisible infrared rays, it is possible to develop radiation cataracts in workers in hot shops and irradiating the orbit without the use of protective equipment( glasses, masks).

Congenital cataracts are associated with impaired lens differentiation during embryogenesis and are not amenable to conservative treatment.

Congenital cataract

Symptoms of cataract

Depending on the location, cataracts are distinguished:

- polar( front and rear) - located at the anterior or posterior pole
- spindle-shaped - located along the anterior-posterior axis in the center of the
lens - laminated - around the
core -cortical( under the capsule of the oval form)
- nuclear - occupy the entire nucleus
- complete - cloudiness of the entire lens

In terms of development, cataract stages are distinguished: initial, immature, mature and overripe.

When the initial changes begin at the periphery, a decrease in vision is absent or insignificant. Is susceptible to conservative treatment.

Initial cataract

When immature, the degree of turbidity increases and vision falls. Perhaps the development of swelling cataracts, leading to complications( phacogenic glaucoma).

Immature cataract

Mature is characterized by densification of clouded lens masses and persistent decrease in visual acuity. Surgical treatment is required.

Mature cataract

Perezrelaia cataract( milk, Morgania) is rare. In this case, the cortical substance disintegrates, the dense core separates from the capsule and "settles" on its bottom. It can be complicated by glaucoma( because inflammation occurs) and iridocyclitis when the capsule bursts and the lens masses exit into the anterior and posterior chambers of the eye. Treatment is only prompt.

Perezrela cataract

Symptoms in which it is possible to suspect the development of cataracts and seek medical attention:

- reduced visual acuity up to light sensation. If the cloudiness occupies the central part, the patient sees better at dusk, when the pupil expands and the uninfected area of ​​the lens increases;
- the lens can acquire a gray color.

If you have any of the above symptoms, you should consult your doctor to clarify the diagnosis.

Diagnosis of cataract

Methods of examination:

- determination of visual acuity( from normal to light and blindness).In normal retina, a light-sensation with a correct projection. Otherwise, surgical treatment will not restore vision, but can save the eye, as an organ.
- perimetry for determining the condition of the retina and diagnosing possible complications;
- determination of intraocular pressure to exclude glaucoma. If necessary, tonography;
- examination in transmitted light. With cataracts against the background of the pink reflex of the fundus, shadows from the cloudy lens are determined;
- biomicroscopy allows to determine the localization and degree of turbidity;
- examination of the fundus to exclude concomitant pathology.

Based on these studies, the doctor can diagnose, but to determine the reasons, additional methods and consultations are needed:

- general clinical tests, including blood sugar;
- consultations of a therapist, an ENT, a dentist for the elimination of concomitant pathology and detection of contraindications for surgical treatment( active inflammatory processes, severe decompensated diseases).

Treatment of cataract

Treatment should be initiated in time, it can be conservative and surgical.
Conservative treatment methods include the appointment of drops that help improve the metabolism( metabolism) of the lens, to slow the progression of opacities. These include Taufon, Quinaks, Oftan-katakrom. Bury 1-2 drops in the conjunctival sac 3 times a day constantly. Breaks in treatment contribute to the progression of the disease.

Surgical methods of treating cataracts are often used. With the development of medicine, you do not even need to go to a hospital. Some operations are performed without cuts, outpatient, and the patient leaves home the same day.

Methods for the surgical treatment of cataracts:

- intracapsular cataract extraction - a historical method, is not currently used due to high traumatism and development of complications. In this case, the lens is removed completely with the capsule;

- extracapsular extraction of cataracts - removal of clouded masses with preservation of the capsule and replacement of its intraocular lens( IOL), which performs all functions of the lens. IOLs are rigid and flexible. Now almost always use the latter.

One of the most common methods of treatment is phacoemulsification of cataracts with IOL implantation. A microcut is used, the lens masses are removed by ultrasound and the IOL is implanted. The whole procedure takes about 10 minutes. Anesthesia is local, which reduces the risk of complications. The patient is prescribed drops, and he goes home under the supervision of the oculist at the place of residence.

Postoperative treatment:

- antibacterial drops( Floxal, Tobrex, Oftakwix) first every hour, then 4 times a day for 10 days,
- anti-inflammatory drops( Indocollir, Diclof) 2 times a day 2 weeks,
- hormonal drops( Oftan-dexamethasone, Maxexex) every 12 hours for 2 weeks,
- for dry eyes appoint tear replacements( Artificial Tear, Systemin, Oxal) - drip as needed.

After operation, it is contraindicated lifting of gravity, being in dusty rooms and outdoors in windy weather, hypothermia, taking baths.

There are folk methods of treatment, for example, instillation of diluted honey into the eyes, ingestion of calendula, sage infusion, etc., but their effectiveness is not proven, and some substances can do harm.

Complications of cataract

In case of untimely or independent treatment, complications can occur:

- complete blindness
- phacogenic glaucoma
- fakolitic iridocyclitis
- dislocation of the lens

Cataract is the main cause of blindness, but with timely treatment it is almost always possible to restore vision.

Doctor ophthalmologist Letyuk T.Z.