Management of Cataract

Signs and Symptoms of cataract:


Decreased visual acuity:This is the commonest presenting feature. The degree of loss of vision will depend on the type and grade of cataract. Even a small posterior sub-capsular opacity may lower vison for near work, to a great extent.
Glare and loss of Contrast Sensitivity:Glare increases due to cataract and it occurs due to scattering of light from the cataract. Loss of contrast sensitivity due to cataract makes it difficult to perform tasks in low light situations.
Myopic Shift:Increase in nuclear cataract may increase the diopteric power of the lens, and this may lead to the feeling that the requirement for glasses for distance as well for reading has diminished. This phenomenon is very often referred to as “second sight”.
Monocular Diplopia:Occasionally, the cataractous changes may occur irregularly, resulting in multiple refractile areas within the lens. This may result in diplopia (double vision) or at times polyopia.

Preoperative Tests:


  • External examination
  • Slit lamp examination
  • Retina evaluation
  • Special Test – Potential Acuity Estimation, Visual Fied Testing
  • Biometry
  • Corneal Topography
  • Evaluation of General Health
  • Indications for Cataract Surgery:


  • Desire for improved of visual function, is the commonest indication.
  • Phacolytic glaucoma
  • Phacomorphic glaucoma
  • Phacoantigenic uveitis
  • Dislocation of lens
  • In situations where cataract obscures fundus view and management of other ocular
  • diseases are impaired.
  • In any situation where, cataract adversely affects daily activities
  • Surgery for cataract:


  • Intra-capsular Cataract Extraction
  • Extra-capsular Catarct Extraction
    1. Small incision Cataract Surgery
    2. Phaco-emulsification
    3. Femtosecond laser assisted Cataract Surgery

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