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Cataracts
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Cataracts

See also in: External and Internal Eye
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Contributors: Brandon D. Ayres MD, Christopher Rapuano MD, Harvey A. Brown MD, Sunir J. Garg MD
Other Resources UpToDate PubMed

Synopsis

A cataract is a change in the clarity of the natural crystalline lens. The development of a cataract is an age-related phenomenon and is more common in elderly individuals. The etiology of the color change is likely a change in water and protein content of the lens and possibly oxidative damage. There are 3 major types of cataracts, and each tends to present with different symptoms. Typically, a cataract will cause slow progressive blurring of vision; however, a nuclear sclerotic cataract (generalized clouding of the lens) can increase the refractive power of the lens inducing myopia, allowing reading vision without the use of glasses. Cortical cataracts (spoke-like opacities in the outer layers of the lens) often cause glare with oncoming light. Posterior subcapsular cataracts (web-like opacities at the posterior pole of the lens) can be highly symptomatic with blurred vision, even when very small. Cataracts can further be classified by severity, from immature (scattered opacities) to mature (totally opaque) to hypermature / Morgagnian (swollen, starting to liquify).

Although cataract formation is a naturally occurring event, several medical conditions can predispose or accelerate formation. Patients with diabetes, hypocalcemia (hypoparathyroid), myotonic dystrophy, high myopia, and inherited metabolic conditions may form cataracts earlier in life. Ocular trauma can also rapidly induce cataract formation. Some medications are associated with the development of cataracts; prolonged use of glucocorticoids is a risk factor for formation of posterior subcapsular cataracts.

Related topic: Congenital cataract

Codes

ICD10CM:
H26.9 – Unspecified cataract

SNOMEDCT:
193570009 – Cataract

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

The differential diagnosis for reduced vision is extensive; the more common diagnoses in an elderly population include:
Rapidly progressive loss of vision is not typical of cataracts. In these patients, other reasons for visual loss should be ruled out before attributing it to cataracts.

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Updated: 12/06/2017
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Cataracts
See also in: External and Internal Eye
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Cataracts : Blurred vision, Bilateral, Diplopia, Vision loss, Opaque lens
Clinical image of Cataracts
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