Disease of lens

1. Disease of lens

2. Lens Anatomy lens capsule + lens fibe Charactertransparent avascular nourishment come from aqueous humor

3. Cataract

4. General description of cataract Definition When there are changes of aqueous humor component osmotic character of lens capsule metabolic disturbance caused by various factors lens protein degeneration transparent lens becomes opaque called cataract

5. According to Classification Cause age-related traumatic complicated Age occurred congenital acquired Site of opacity nuclear cortical capsular subcapsular Shape of opacity punctate coronary lamellar Degree of opacity incipient immature mature hypermature

6. Clinical findings Progressive blurred vision Contrast sensitivity change Increase in the refractive index Monocular diplopia or polyopia Dazzle Change of color sensation Defect of visual field

7. Age-related cataract (senile cataract)Clinical findingsprogressive blurred vision3 categoriescortical cataractnuclear cataract subcapsular cataract

9. Cortical cataract • 4 stages • incipient stage • intumescent stage or immature stage • mature stage • hypermature stage

10. Incipient stage cuneiform opacity in peripheral tip towards to centre pupillary area not affected difficult to find without mydriasis no blurred vision take place

11. Intumescent stage uneven milk-white opacity vision decrease obviously fundus difficult to be seen swollen cortex ---push iris forward ---shallow anterior chamber---glaucoma be careful to mydriasis

12. maturestage • entire lens appear as grey-white opacity • fundus can not to be seen • vision decrease to FC or HM • swollen cortex decrease---normal anterior chamber

13. Hypermature stage—Morgagni cataract • cortex fibers decomposed • entire lens reduced capsule shrank • nucleus fallen down • anterior chamber become deeper • iridodonesis • vision increase • lens-induced uveitis • Phacolytic glaucoma

14. nuclear cataract • develop slowly • from embryonic nucleus to adult’s nucleus • grey-yellowish in centre • less affect vision in early stage

17. Posterior subcapsular cataract • at subcapsular cortex in posterior pole of lens • appear as plate shape • blurred vision take place in early stage

19. Congenital cataract Etiology Genetic factor autosomal dominant inheritance Environmental factor viral infection rubella nourishment disturbance Vit D

20. Congenital cataract • Morphology • anterior polar cataract • posterior polar cataract • perinuclear or zonular cataract • coronary cataract • total cataract

22. Complicated cataract • Induced by ocular inflammation or degenerative disorders • Anterior segment disorder---cortex opaque • Posterior segment disorder---nucleus opaque

23. Metabolic cataract • diabetic cataract • galactose cataract • tetany cataract

24. Diabetic cataract • Combine with senile cataract • Single diabetic cataract

25. Tetany cataract • Hypocalcemia • After extraction of parathyroid

26. Drug-induced or toxic cataract • Glucocorticosteroid cataract • Chlorpromazine cataract • Miotic cataract • Trinitrotoluence cataract • Metal-induced cataract

27. Traumatic cataract • Contusive cataract • Penetrating cataract • Radiative cataract • Electric cataract

28. After cataract • After extracapsular cataract extraction or aspiration of lens • Symptom blurred vision • Treatment YAG laser

29. Dislocated lens • Hereditary lens dislocation • Traumatic lens dislocation partial dislocation completely dislocation

30. Surgery of cataract Occasion Examination Method

31. Surgery procedures • Intracapsular cataract extraction Extracapsular • cataract extraction + IOL implantation ECCE + IOL • Phacoemulsifaction + IOL implantation PHACO + IOL

32. Intracapsular cataract extraction

34. 人工晶状体

37. 白内障现代囊外摘除术+人工晶体植入术ECCE+IOL