Ophtha Case Report - Copy

8/11/2019 Ophtha Case Report - Copy

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C.R

57/MMarried

Patient Profile


3/17

3 yrs PTC, px noted gradual blurring of vision of

the right eye

(-) eye pain

(-) redness

(-) tearing

(-) dicharge

CONSULT

History of Present Illness


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Past Medical History

HTN (Amlodipine, 2 yrs)

Past Ocular History

Unremarkable

Family History

Unremarkable

History of Present Illness


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SUDDEN GRADUAL TRANSIENT

PAINLESS PAINFUL

Ischemic Optic

Neuropathy Retinal

Artery/VeinOcclusion

Acute Angle

ClosureGlaucoma Corneal Ulcer Uveitis with

Complications

Cataract

Error ofRefraction Open Angle

Glaucoma DM

Retinopathy Age-related

MacularDegeneration

Subacute

AngleClosureGlaucoma

Uveitis Optic

Neuritis Uveitis

Papilledema

AmaurosisFugax

Differential Diagnosis


7/17

Cataract57 y/oLeukocoria

Error of Refraction Not improved with pinhole

Open Angle Glaucoma Normal IOP

DM Retinopathy No DM

Age-related Macular Degeneration Central vision is not affected

Gradual, Painless


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Cataract Senile Mature, OD

Assesment


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Pathogenesis

not completely understood.

cataractous lensesprotein aggregates thatscatter light rays and reduce transparency.

Factors:

oxidative damage (from free radical reactions)

ultraviolet light damage

malnutrition

NO medical treatment to retard or reversecataract formation.

protective effect from dietary carotenoids (lutein)

Cataract


11/17

Mature All of the lens protein is opaque Leukocoria

Immature Some transparent protein Black opacity against a red orange background

Intumescent Lens take up water

Hypermature

Cortical proteins have become liquidescapeshrunken lenswith wrinkled capsule

Morgagnian Hypermature cataract in which lens nucleus floats freely in the

capsular bag

Cataract


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Most common type

Age-related

Types

Nuclear

Cortical

Subcapsular

Senile Cataract


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Nuclear (Hard) Cataract

Hardening of the nucleus d/t compacting &

sclerosing of the lens fiber in the center of the lensyellow-brown pigments

Myopic shift in refraction

Early onset of BOV (Far vision)

Senile Cataract


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Cortical (Soft) Cataract

Hydration of the cortex with development of

subcapsular vacuoles which disrupts regulararrangement of lens fiber

Opacity begins at periphery (radial spoke-like

opacities)

Late onset of BOV

Senile Cataract


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Posterior Subcapsular Cataract

cortex near the central posterior capsule.

Posterior migration of lens epithelium

Near vision is affected early

Associated with DM, trauma, corticosteroid use

(topical or systemic), inflammation, or exposure to

ionizing radiation.

Senile Cataract


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Phacoemulsification

Latest method

Use of ultrasonic vibrator to

disintegrate nucleus Sutureless

Procedure:

Capsulorrhexis

Hydrodissection

Sculpting of the Nucleus Cracking of the Nucleus

Emulsification

Removal of Cortex

Insertion of IOL

Management of Cataract

Documents

Ophtha Case Report - Copy