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An Asian woman with blurred vision
Published in Tim French, Terry Wardle, The Problem-Based Learning Workbook, 2022
Impaired vision and failing eyesight are important issues to the health and well-being of many people. In the UK, cataracts remain the most common cause of visual impairment in the elderly. Cataract extraction continues to be one of the most common and successful surgical procedures, largely due to the development of small-incision surgery and faster rehabilitation. Diabetes predisposes to the early development of both cataracts and retinopathy, and visual impairment is frequently a feature of the disease. This scenario uses the backdrop of type 2 diabetes to explore visual impairment, specifically cataracts and diabetic retinopathy.
The crystalline lens
Published in Mary E. Shaw, Agnes Lee, Ophthalmic Nursing, 2018
If no complications occur, dislocated lenses are best left untreated. If complications do occur, treatment should be given to the complications before cataract extraction is attempted, as surgery in these instances is difficult.
Complications of anterior segment surgery
Published in Thomas H. Williamson, Vitreoretinal Disorders in Primary Care, 2017
An increased risk of retinal detachment is associated with a previous cataract extraction operation. Approximately 30% of RRDs are pseudophakic.54 When the cataract surgery has been complicated by vitreous loss, the vitreous disruption results in a PVD or in further shrinkage of the vitreous and retinal tear formation. However, even uncomplicated cataract surgery seems to induce a risk of retinal detachment. It may be that the loss of the larger volume of the crystalline lens by the lower volume of the IOL implant induces a change in the vitreous, inducing vitreous detachment, which in turn, increases the risk of retinal break formation. The retinal detachment risk appears at a mean of 15 months after the surgery. These patients may experience floaters and flashes but often present late and with their macula detached.
CircPAG1 Inhibits the High Glucose-Induced Lens Epithelial Cell Injury by Sponging miR-630 and Upregulating EPHA2
Published in Current Eye Research, 2021
Youyi Yang, Qianqian Li, Xin Zhang, Gangfeng Cui
Diabetes mellitus (DM) is a chronic systemic disease that can evoke severe complications, including ocular diseases.1 Cataract is the most important cause of visual impairment and blindness all over the world. Diabetic cataract (DC) is a common ocular complication resulting from DM, and DM patients have a higher risk of cataract than the rest of the populations.2,3 Although the technical procedures for cataract surgery have been mature, the prognosis remains poor due to various complications after cataract extraction.4 High glucose (HG) can induce apoptosis and oxidative stress of human lens epithelial cells to further result in lens opacity in the pathological process of DC.5 Thus, discovering efficient biomarkers may be pivotal for the diagnostic and therapeutic management of DC.
Clinical, Socio-economic and Environmental Factors Related with Recurrences in Ocular Toxoplasmosis in Quindío, Colombia
Published in Ophthalmic Epidemiology, 2021
Stefany Velasco-Velásquez, Daniel Celis-Giraldo, Andrea Botero Hincapié, Diego Alejandro Hincapie Erira, Sara Sofia Cordero López, Nathalia Marulanda Orozco, Jorge Enrique Gómez-Marín
Another factor considered is the antecedent of a previous intraocular surgery in which evidence demonstrated increased risk in 14 patients undergoing cataract extraction in contrast to 45 control patients.11 Regarding age, Holland et al. divided a study population into those >40 years of age and those <40 years of age, finding that patients >40 years had a higher risk of recurrence in the multivariate analysis (p = .03).19 Other authors found a higher recurrence rate in patients <20.9 years (p = .05),18 finding a contradiction with the study by Holland et al. An additional risk factor is precipitation; the study by Rudzinski M. et al. analysed the association between the number of reactivations and precipitation per quarter for 5 years. A total of 86 reactivations were obtained with an average annual total rainfall of 1,580.83 mm. Regarding recurrence episodes in OT, there was higher frequency during the third quarter of the year; however, no statistically significant association was found between quarterly adjustments and reactivations, but it was shown that precipitation is a predictor of recurrence frequency (p = .019) so that for each mm of precipitation, there is an increase of 2 episodes (OR = 1.002 CI = 1.000–1.003).20 These results are similar to other studies associating annual precipitation with higher incidence of congenital toxoplasmosis.21
Exploring microperimetry and autofluorescence endpoints for monitoring disease progression in PRPF31-associated retinopathy
Published in Ophthalmic Genetics, 2021
Danial Roshandel, Jennifer A. Thompson, Jason Charng, Dan Zhang, Enid Chelva, Sukanya Arunachalam, Mary S. Attia, Tina M. Lamey, Terri L. McLaren, John N. De Roach, David A. Mackey, Steve D. Wilton, Sue Fletcher, Samuel McLenachan, Fred K. Chen
BCVA at baseline was hand motion in two patients and the remaining ten had a mean (SD, range) BCVA of 58 (14, 36–75) ETDRS letters (Snellen equivalent of 20/80, 20/200-20/40) in the right eye at a mean (SD) age of 28 (11) years. Five patients (10 eyes) had cataract and two of these underwent bilateral sequential cataract extraction and intraocular lens implantation during the follow-up period. Fundus examination showed variable degrees of intraretinal pigmentation in patients older than 20 years (n = 9). The degree of retinal pigmentation was different in affected family members at similar ages (Figure S2). Optic disc drusen was seen in three family members (II:3, III:2 and III:5) and clinically visible cystoid macula oedema (CMO) was seen in two younger family members (IV:8 and III:12). One patient (II:6) had an old traumatic full-thickness macula hole in the left eye and two patients (III:1 and III:6) had lamellar macular defects (Table 1).