|Classification and external resources|
Magnified view of cataract in human eye, seen on examination with a slit lamp using diffuse illumination
|ICD–10||H25–H26, H28, Q12.0|
A cataract is a clouding that develops in the crystalline lens of the eye or in its envelope (lens capsule), varying in degree from slight to complete opacityand obstructing the passage of light. Early in the development of age-related cataract, the power of the lens may be increased, causing near-sightedness (myopia), (second sight), and the gradual yellowing and opacification of the lens may reduce the perception of blue colors. Cataracts typically progress slowly to cause vision loss, and are potentially blinding if untreated. The condition usually affects both eyes, but almost always one eye is affected earlier than the other.
Types of Cataracts
A senile cataract, occurring in the elderly, is characterized by an initial opacity in the lens, subsequent swelling of the lens and final shrinkage with complete loss of transparency. Moreover, with time the cataract cortex liquefies to form a milky white fluid in a Morgagnian cataract, which can cause severe inflammation if the lens capsule ruptures and leaks. Untreated, the cataract can cause phacomorphic glaucoma. Very advanced cataracts with weak zonules are liable to dislocation anteriorly or posteriorly. Such spontaneous posterior dislocations (akin to the historical surgical procedure ofcouching) in ancient times were regarded as a blessing from the heavens, because some perception of light was restored in the cataractous patients.
Some children develop cataracts, called congenital cataracts, before or just after birth; these are usually dealt with differently from cataracts in adults.
Posterior Subcapsular Catarcts are often associated with steroid use or diabetes and tend to progress fairly quickly. They cause glare and trouble with reading if they are central.
Cataract derives from the Latin cataracta meaning “waterfall” and that from the Greek καταράκτης (kataraktēs) or καταρράκτης (katarrhaktēs), “down-rushing”, from καταράσσω (katarassō) meaning “to dash down” (from kata-, “down”; arassein, “to strike, dash”). As rapidly running water turns white, the term may later have been used metaphorically to describe the similar appearance of mature ocular opacities. In Latin, cataracta had the alternate meaning “portcullis“ and it is possible that the name passed through French to form the English meaning “eye disease” (early 15c.), on the notion of “obstruction”. Early Persian physicians called the term nazul-i-ah, or “descent of the water”—vulgarised into waterfall disease or cataract—believing such blindness to be caused by an outpouring of corrupt humour into the eye.