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

Figure 11.7. An elderly person cannot read without glasses unless he or she is myopic. Myopia in the elderly can be caused by cataract. ("Rembrandt's mother" with acknowledgement to Rijksmuseum-Stichting.) £Q

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.

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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