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University of Massachusetts Medical School eScholarship@UMMS

PEER Liberia Project UMass Medical School Collaborations in Liberia

2020-06-15

Ophthalmology Lecture 3:

Louis Oteng-Gyimah Sunyani SDA Hospital

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Repository Citation Oteng-Gyimah L. (2020). Ophthalmology Lecture 3: Cataract. PEER Liberia Project. https://doi.org/ 10.13028/zxas-4f91. Retrieved from https://escholarship.umassmed.edu/liberia_peer/42

This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in PEER Liberia Project by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. CATARACT ELWA Family Medicine Residency Program LOUIS OTENG-GYIMAH, MBChB, MGCS OPHTHALMOLOGIST @ SUNYANI SDA HOSPITAL BONO REGION, GHANA OUTLINE INTRODUCTION EPIDEMIOLOGY AND CAUSES OF CATARACT TYPES OF CATARACT CLINICAL FEATURES OF CATARACT TREAMENT AND COMPLICATIONS OF CATARACT An opacity in the is called a ‘cataract’ (Greek: waterfall), because vision is similar to looking through a waterfall. INTRODUCTION  It is the leading cause of worldwide  Cataract is the second leading cause of after  The burden of visual impairment is not borne equally.  Visual impairment ranks behind arthritis and heart disease as the third most common chronic cause of impaired function in persons older than 70 years.  Patients with vision impairment are more likely to fall, make medication errors, have depression, or report social isolation.  With rehabilitation, many patients with impaired vision can attain independence, retain their jobs, and lessen their reliance on social services and institutions. Vision impairment that could have been prevented or has yet to be addressed  Unaddressed (826 million)  Unaddressed refractive error (123.7 million)  Cataract (65.2 million)  (6.9 million)  Corneal opacities (4.2 million)  Diabetic (3 million)  (2 million)  Greater burden amongst Low- and middle-income countries Under-served populations such as Women Migrants Persons with certain kinds of ,  Rural communities.  Blindness prevalence varies between 0.4% (in developed regions ) and 1.5% (in poor underserved regions ) in different population  Cataract is responsible for between 40%-55% of all blindness worldwide  Research has shown that the prevalence of blindness in Liberia is estimated at 1 percent, with an estimated total of 35,000 blind people. Cataract is the major cause of blindness in Liberia, with an estimated backlog of 17,500 people or 50 percent of the total blind population and the lens

 Various degenerative and ageing changes occur in the lens, probably because of its unusual structure.  These changes occur to some degree in everyone, as they grow older. 1. Increase in hardness and loss of 2. Increase in density 3. Increase in size 4. Increase in opacity RISK FACTORS 1. The biggest risk factor for cataract is age. 2. Life in tropical countries and poor countries increases the risk of developing cataract.  Episodes of severe dehydration in early life  Solar radiation  Diet  Heat 3. Some diseases cause or are associated with cataract.  Eye diseases and cataract   Glaucoma  Trauma

CATARACTS

 The lens is avascular  It lies behind the  It is attached to the ciliary muscle by the zonules  It is made up of fibres derived from the anterior lens capsule  The nucleus is the oldest part of the lens  Fibres are continuously added around the nucleus throughout life, forming the cortex

THANK YOU REFERENCES  IN HOT CLIMATES, 5TH EDITION, DISEASES OF THE LENS  AMERICAN ACADEMY OF OPHTHALMOLOGY, LENS AND CATARACT, BCSC 11, 2019  CATARACT LECTURE BY AUDI ADIBAH et.al GLAUCOMA …….Our next topic