Overview
Definition
A clouding or opacification of the normally clear crystalline lens of the eye.
Epidemiology
Extremely common in the elderly. The leading cause of reversible blindness worldwide.
Etiology & Risk Factors
- Senile (age-related) - most common
- Trauma
- Metabolic (Diabetes accelerates formation)
- Medications (Prolonged Corticosteroid use)
- Congenital (TORCH infections like Rubella)
Clinical Symptoms
- Slowly progressive, painless, bilateral vision blurring
- Difficulty driving at night due to severe glare from headlights
- Faded colors
- Myopic shift ('second sight' - temporary improvement in near vision)
Clinical Approach
Diagnosis
- Slit-Lamp Examination: Direct visualization of lens opacities
- Ophthalmoscopy: Diminished red reflex
Management
- Early stages: Updated prescription glasses
- Definitive Treatment: Phacoemulsification (surgical removal of the cloudy lens) with Intraocular Lens (IOL) implantation
- Surgery is indicated when the visual impairment interferes with activities of daily living (ADLs)
Complications
- Complete blindness (reversible with surgery)
- Phacomorphic glaucoma (swollen lens blocks aqueous outflow)