University of Massachusetts Medical School eScholarship@UMMS PEER Liberia Project UMass Medical School Collaborations in Liberia 2020-06-15 Ophthalmology Lecture 3: Cataract Louis Oteng-Gyimah Sunyani SDA Hospital Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/liberia_peer Part of the Eye Diseases Commons, Family Medicine Commons, Medical Education Commons, and the Ophthalmology Commons 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 lens is called a ‘cataract’ (Greek: waterfall), because vision is similar to looking through a waterfall. INTRODUCTION It is the leading cause of blindness worldwide Cataract is the second leading cause of visual impairment after refractive error 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 presbyopia (826 million) Unaddressed refractive error (123.7 million) Cataract (65.2 million) Glaucoma (6.9 million) Corneal opacities (4.2 million) Diabetic Retinopathy (3 million) Trachoma (2 million) Greater burden amongst Low- and middle-income countries Under-served populations such as Women Migrants Persons with certain kinds of disability, 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 Ageing 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 accommodation 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 Uveitis Glaucoma Trauma CATARACTS The lens is avascular It lies behind the iris 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 EYE DISEASE 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.