Ophthalmology Clerks: Alea, Denz Marc Custodio, Audreyfil Perez, Francis Miguel

Ophthalmology
Clerks
Alea, Denz Marc
Custodio, Audreyfil
Perez, Francis Miguel
Case Presentation
This is a case of JY, a 65-year-old male, protestant
presents with blurring of vision on right eye which
made it difficult for for him to cope with everyday life.
Patient experiences dizziness somtimes while
reading newspapers because of the blurring, which
prompted him to consult an ophthalmologist.
.
Chief Complaint: Blurring of vision OD
History of Present Illness:

Two months prior to admission, the patient experienced
blurring of vision, he immidiately went to our institution for
consult, the doctor advised him to undergo cataract surgery.
One day prior to procedure, the patient went to our hospital
to be admitted for the surgery.
.
Past ocular History: No history of eye surgery or trauma.
Past Medical History

Hypertension 2010
Medications: Losartan 50mg, Amlodipine 5mg
Family History: Paternal DM, Maternal HPN

Social History: No current alcohol or tobacco use
Review of Systems: A full review of systems showed no
abnormalities.
Physical Examinations
Vitals
BP: 120/70
PR: 62
RR: 20
Temp: 36.0 C
Height: 160cm
Weight: 59kg
BMI: 23.05 (normal)
Physical Examinations
OCULAR EXAMINATION
Visual acuity at distance without correction:

Right eye (OD): 0/0, can see hand gestures
Left eye (OS): 20/100
Ocular motility: Full both eyes (OU)
Pupils: Equally reactive in each eye 2mm in the light. No

relative afferent pupillary defect.
Dilated Fundus Exam
OD: No view secondary to the dense cataract
OS:
Vitreous: Clear
Optic Nerve: Sharp border, no edema
Macula: Normal
Vessels: Normal
Periphery: Normal
Differential Diagnosis
Glaucoma
Macular Degeneration
Optic neuritis
Corneal Disease
Cataract
Diagnosis
Cataract, near mature OD
Discussion
The appearance of the patient's lens in the right eye was

consistent with a near mature cataract. This cataract was
causing significant blurring of vision of the right eye. The
surgical procedure to be done is Cataract extraction and
IOL replacement.
What is Cataracts?
A cataract is a clouding of the lens in the eye that affects vision.

Most cataracts are related to ageing and can occur in either or
both eyes. It cannot spread from one eye to the other.
The lens is made of mostly water and protein where the protein is
arranged in a precise way that keeps the lens clear and lets light
pass through it.
But as we age, some of the protein may clump together and start
to cloud a small area of the lens which is called cataract.
Over time, the cataract may grow larger and cloud more of the
lens, making it harder to see.
Factors that increase the risk of cortical cataracts like chronic

sunlight exposure, uncontrolled diabetes are the risk factors.
Signs
.
Decreased visual acuity - gradually progressive,
painless
Dense nucleus floating freely in the liquified cortex
Flecks of calcium deposits in the anterior capsule may
be seen
Absence of red fundus glow in retinoscopy (red reflex)
Symptoms
Blurring and clouding of vision, decreased vision at

near and distance
Management
Surgical removal of the cataractous lens followed by
intraocular lens implantation is the treatment modality of
choice.
Surgery:
Phacoemulsification cataract extraction followed by intraocular
lens implantation (posterior chamber intraocular lens (PCIOL )
Phacoemulsification is a modern cataract surgery in which

the eye's internal lens is emulsified with an ultrasonic
handpiece and aspirated from the eye. Aspirated fluids are
replaced with irrigation of balanced salt solution to maintain
the anterior chamber.
.
Surgical Complications:
Uncontrolled radial tear of anterior capsule
Posterior capsular rent
Nuclear drop into the vitreous
Endothelial cell damage
Prognosis:
counselling should be done with patient about the increased
risk of complications and the possible need of more than one
surgeries to achieve the best visual outcome.
Preoperative assessment for projection of light and relative
afferent pupillary defect are important prognostically.
Patients should also be explained about the possible binocular
diplopia due to a longstanding loss of fusion.
END
THANK YOU!

Ophthalmology Clerks: Alea, Denz Marc Custodio, Audreyfil Perez, Francis Miguel

Uploaded by

Copyright:

Available Formats

Ophthalmology Clerks: Alea, Denz Marc Custodio, Audreyfil Perez, Francis Miguel

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Ophthalmology Clerks: Alea, Denz Marc Custodio, Audreyfil Perez, Francis Miguel

Uploaded by

Copyright:

Available Formats

Ophthalmology

Chief Complaint: Blurring of vision OD

History of Present Illness:

Past Medical History

Medications: Losartan 50mg, Amlodipine 5mg

Family History: Paternal DM, Maternal HPN

Visual acuity at distance without correction:

Ocular motility: Full both eyes (OU)

Pupils: Equally reactive in each eye 2mm in the light. No

OD: No view secondary to the dense cataract

The appearance of the patient's lens in the right eye was

A cataract is a clouding of the lens in the eye that affects vision.

Factors that increase the risk of cortical cataracts like chronic

Blurring and clouding of vision, decreased vision at

Phacoemulsification is a modern cataract surgery in which

You might also like