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Key Features

  • Lens opacity (may be grossly visible)

  • Usually occurs bilaterally

  • Age-related cataract is the most common type

  • Most persons older than 60 have some degree of lens opacity

  • Multivitamin/mineral supplements and high dietary antioxidants may prevent the development of age-related cataract

  • Other causes

    • Congenital infections or inborn errors of metabolism

    • Secondary to systemic disease (diabetes mellitus, myotonic dystrophy, atopic dermatitis)

    • Drugs (eg, topical, systemic, or inhaled corticosteroids [long-term])

    • Uveitis

    • Radiation exposure

    • Ocular trauma

Clinical Findings

  • Gradually progressive blurred vision

  • No pain or redness

Diagnosis

  • Ophthalmoscopy, particularly with a dilated pupil, shows opacities in the red reflex

  • As the cataract progresses, retinal visualization becomes increasingly difficult

Treatment

  • When visual impairment significantly affects daily activities, surgical therapy is usually warranted

  • Treatment involves surgical removal and insertion of an intraocular lens of appropriate refractive power

  • Risk of intraoperative (floppy iris syndrome) and postoperative complications is increased in patients taking

    • α1-Adrenergic receptor antagonists (eg, tamsulosin, alfuzosin, doxazosin, silodosin, or terazosin)

    • Risperidone

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