At primary care level, it is important to be able to diagnose cataract but also to understand the benefits and risks of cataract surgery in order to
be able to give the patient advice as to when the cataract is bad enough to need an operation. An understanding of the meaning of aphakia and the optical consequences of an implant are also useful. Most patients who present with cataracts are diagnosed as having age-related cataracts and investigations as to the cause are limited to tests to exclude diabetes and to confirm that the patient is fit for surgery. An understanding of the symptoms of cataract is helped by understanding the meaning of index myopia.
Figure 11.7 is a final reminder of the signs and symptoms of cataract. An elderly woman would not normally be able to read small print without glasses and this lady's eyes must be abnormal. She might have inherited myopia, allowing her to see near objects without the need for a presbyopic lens, but the myopia could also be index myopia, which in turn could be caused by early cataract formation. Another cause of index myopia could be uncontrolled diabetes.
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All you need is a proper diet of fresh fruits and vegetables and get plenty of exercise and you'll be fine. Ever heard those words from your doctor? If that's all heshe recommends then you're missing out an important ingredient for health that he's not telling you. Fact is that you can adhere to the strictest diet, watch everything you eat and get the exercise of amarathon runner and still come down with diabetic complications. Diet, exercise and standard drug treatments simply aren't enough to help keep your diabetes under control.