Cataracts

Last reviewed: 21 Apr 2022
Last updated: 23 Nov 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • subjective decrease in vision
  • blurred or cloudy vision
  • glare
  • washed-out colour vision
  • reduced visual acuity
  • defects in the red reflex
More key diagnostic factors

Other diagnostic factors

  • inadequate glasses prescription
  • disruption in activities of daily living
Other diagnostic factors

Risk factors

  • age >65 years
  • female sex
  • smoking
  • long-term UV exposure
  • diabetes mellitus
  • other metabolic or hereditary conditions
  • exposure to ionising radiation
  • eye trauma
  • long-term corticosteroid use
  • family history of congenital cataract or congenital influences (e.g., toxins)
  • uveitis
  • myopia
More risk factors

Diagnostic investigations

1st investigations to order

  • dilated fundus examination
  • measurement of intra-ocular pressure
  • glare vision test
  • slit lamp examination of the anterior chamber
More 1st investigations to order

Investigations to consider

  • assessment of best visual potential
More investigations to consider

Treatment algorithm

ACUTE

cataract without concomitant eye pathology

cataract with concomitant eye pathology

ONGOING

post-surgical opacification of the posterior capsule + significant visual impairment

Contributors

Authors

Robert T. Chang, MD

Associate Professor of Ophthalmology

Byers Eye Institute

Stanford University School of Medicine

Stanford

CA

Disclosures

RTC declares that he has no competing interests.

Acknowledgements

Dr Robert T. Chang would like to gratefully acknowledge Dr Creig Hoyt, Dr Leela V. Raju, and Dr M. Bowes Hamill, previous contributors to this topic.

Disclosures

CH, LVR, and MBH declare that they have no competing interests.

Peer reviewers

Michael P. Ehrenhaus, MD

Assistant Professor of Ophthalmology

Cornea External Disease and Refractive Surgery Local Director

Long Island College Hospital Eye Center

Brooklyn

NY

Disclosures

MPE declares that he has no competing interests.

Parwez Hossain, PhD, FRC Ophth, FRCS(Ed)

Associate Professor/Consultant in Ophthalmology

University of Southampton

Southampton

UK

Disclosures

PH declares that he has no competing interests.

Bob Avery, MD, PhD

Assistant Professor

Ophthalmology

University of New Mexico Medical School

Albuquerque

NM

Disclosures

BA declares that he has no competing interests.

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