Cataract: etiology, epidemiology, symptoms, diagnosis, treatment

Gabrielė Kapūstienė1, Ignė Dumbliauskaitė1

1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine

Summary

A cataract is an eye disease when the lens inside the eye loses its transparency, which leads to reduced vision and quality of life. It is one of the most common causes of blindness in the world, and its prevalence varies from region to region. There are several types of cataract: age-related, secondary and traumatic. Age-related cataract is further divided into nuclear, cortical, and posterior subcapsular. Age-related nuclear cataracts are the most common. It is the multifactorial disease, whose development depends not only on genes but on environmental influences as well. Risk factors that may lead to the development of cataracts include smoking, poor nutrition, low physical activity, high exposure of ultraviolet sunlight and comorbidities. These factors need to be adjusted to prevent cataract. This eye disease is painless and slowly progressing. Patients usually complain of a slowly progressive vision disorder, blindness in one or both eyes and first present to examination when they have symptoms of reduced vision that affect their daily life. Symptoms such as a decreased evaluation of contrasts and colors, doubling of one eye, and discoloration of the pupil may also be affected. As with any disease, a complete medical history is required during cataracts. The patient’s family history, life history and illness history should be clarified. A history of medication use is also very important because certain groups of drugs may promote the development of cataracts and influence the choice of the surgery technique. Then an ophthalmologic examination of the patient is required, which involves an evaluation of visual acuity, and direct or indirect ophthalmoscopy to detect an altered or lost red eye reflex and a clouded lens. Unfortunately, there is no medicamentic or non-surgical treatment for this condition.  Visual acuity at the primary stages can be adjusted by prescribing glasses. The main treatment for cataracts is surgery. There are three types of surgery: intracapsular extraction, extracapsular extraction, and phacoemulsification. The most popular cataract surgery is phacoemulsification because it‘s the least invasive operation that causes the least amount of adverse reactions, after which vision returns most quickly. During this surgery folding, intraocular lenses are used.

Keywords: cataract, lens, ocular disease, age-related nuclear cataract, multifactorial disease, ophthalmoscopy, intracapsular extraction, extracapsular extraction, phacoemulsification, intraocular lenses.