Cataract – Only a disease of the elderly?

Who is most often affected? Those mainly affected are older than 60 years. Cataracts are, therefore, also often referred to as senile cataract s. Only in very rare cases do children and young people suffer from this disease. The probability is about 50 % in people between the ages of 52 and 64. Between the ages of 65 and 75, cataracts develop in almost everyone. Every year, more than 600,000 patients undergo cataract surgery in Germany. Of these, 90 % subsequently regain a visual performance of 50 to 100 %. Cataracts are the most common cause of blindness worldwide, especially where medical care is inadequate.

What are the causes? Cataracts are mostly a natural consequence of aging. The proteins of the lens break down and form clumps. Cataracts can be due to several other causes, and many causes are considered hereditary. Other causes can be:

Radiation (e.g. UV light from the sun, infrared light, radioactive rays, X-rays, heat rays)

Certain medications such as cortisone

Smoking

Eye injuries ( contusion , open wounds, injuries caused by electro-cution)

Diabetes

Nutrient deficiencies

Skin diseases (such as neurodermatitis ).

In rare cases, cataracts may also be congenital (then due to hereditary causes or due to a complication during pregnancy, such as rubella disease in the mother).

What are the symptoms of cataracts? The incident light is diffusely refracted by the lens opacity . As a result, the glare sensitivity of affected individuals increases sharply. This is often noticed when driving in bad weather conditions. Many symptoms do not usually become apparent until later in the course of the disease. These later-diagnosis symptoms include:

Veil ed vision (occluded)

double vision

loss of contrast

Light glare around objects

Light and dark are no longer adjusted correctly

Spatial vision is severely limited

Limited distance and near vision.

A complete cataract may result in blindness. In this case, the entire lens of the eye is affected. Then early surgery is recommended.

How is cataract diagnosed? A slit-lamp microscope is used for diagnosis. This allows 6–40 × magnification of the lens in the eye. The cornea, the posterior surface and anterior chamber of the eye can also be transilluminated using this microscope. Eye drops are used to dilate the pupil for a short time. The patient, sitting in front of the microscope during the examination , has their cornea examined. If a cataract is suspected , a videokeratoscopy can be performed. In addition, the thickness of the cornea and endothelial cell density are measured. Early detection also plays an important role in this disease. It is recommended to undergo a preventive examination by an ophthalmologist at regular intervals from the age of 40.

How are cataracts treated? Without surgery, cataracts lead to blindness. At the beginning, affected people become short-sighted . An existing age-related long-sightedness can be initially compensated, i.e. affected people then suddenly see clearly again for a short time without glasses. However, vision then continues to decline . The image becomes cloudy and increasingly blurred . As a rule, both eyes are affected by cataracts. The disease progresses at different rates, often faster in younger patients.

Cataracts surgery is performed under local anesthesia on an outpatient basis. The clouded lens is replaced with an artificial lens . There are two methods of lens replacement: intracapsular and extracapsular, in the latter the capsule remains in the eye. Currently, the most common procedure is extracapsular phacoemulsification.

Phacoemulsification: The eye is anesthetized with drops, or an injection. The cut is only 2–3 millimeters long (and subsequent ly heal s on its own). Through this incision – with the help of ultrasound – the nucleus and the cortex of the lens are liquefied , and the liquid is then aspirate d. The lateral and posterior lens capsule remain in place during the surgery and the artificial lens is inserted (folded) into the capsular bag. In the eye, the soft artificial lens spreads and takes its shape. The lens is then anchored in place. After that, an ointment dressing is applied for about 24 hours. Antibiotic and anti-inflammatory eye drops are used for the first four weeks to prevent infections. After about 6–8 weeks the eye is healed. If the second eye needs surgery, an interval of 4 weeks is recommended so that possible complications can be taken into account.

How can cataracts be prevented? According to the current state of medicine, it is not possible to prevent the development of a cataract. However, surgery can largely eliminate the symptoms. Nonetheless, it is important to protect the eyes from UV radiation, for example by wearing sunglasses with tested UV protection.

EXERCISE:

1. These symptoms can appear late in the course of cataracts: A) Veiled vision B) Double vision C) Loss of contrast D) Light glare around objects E) Light and dark are no longer adjusted correctly

2. About 6–8 weeks after surgery the eye is healed. If the second eye needs surgery, an interval of 4 weeks is recommended so that possible complications can be taken into account. A) True B) False

3. Only in very rare cases can children and young people suffer from cataracts. A) True B) False

You’ll find the answer below.

BIBLIOGRAPHY 1. www.aao.org

2. www.augenklinikroth.de

3. www.dict.cc

4. www.mayoclinic.org

5. www.nhs.uk

6. www.webster-dictionary.org

CARMEN LOBITZ Carmen Lobitz ist freie Trainerin, Lehrerin und MTL. Sie gründete 1998 in Berlin lobitz seminare, die unter anderem Englischseminare für Health Professionals anbieten.

Kontakt: mail@lobitz-seminare.de

www.lobitz-seminare.de

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Lösung für Exercise:

1. A)–E)

2. A)

3. A)

Cataract – Only a disease of the elderly?

Who is most often affected?

What are the causes?

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Cataract – Only a disease of the elderly?

Who is most often affected?

What are the causes?

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