![]() ![]() In the primary care setting, recognition of risk factors and the use of screening questions to assess symptoms of visual function (e.g.There is insufficient evidence to recommend routine screening for impaired vision in asymptomatic adults.There are no approved topical treatments for cataract prevention in Canada.Nutritional supplementation has not been shown to reduce the rate of cataract development.Patients who are long-term users of corticosteroids (by any route, dose and duration dependent) should be informed of the increased risk of cataract formation.Patients who are subthreshold for surgery may benefit from lifestyle modification: 1,2 There is an epidemiologic link between cataract development and smoking, steroid use, diabetes, and ultraviolet ray exposure.Chronic Steroid use including topical, systemic, intravitreal, inhaled.The most common risk factors for cataracts include: diabetes, long term use of topical, systemic, intravitreal, inhaled or oral corticosteroids and prior intraocular surgery.In 2018/2019, 69,463 cataract surgeries were performed in B.C.was reported as 21.46/10,000 with cataract as the most common cause (29.9 %). Between 1996-2001, the prevalence of low vision and blindness in all ages in B.C.The management of cataracts is similar irrespective of the type. The nuclear type is more common in the older population 2 whereas the posterior subcapsular (PSC) type can manifest at any age. Cataract types are defined by their specific location of opacity or clouding within the anatomical lens and include: nuclear, cortical, subcapsular (anterior and posterior), and mixed.2 Younger age of onset can be due to trauma, radiation, diabetes or steroid use. A cataract is a progressive clouding of the lens in the eye that interferes with vision 1 and the examiner’s view of the fundus.Post-operative patients should be urgently assessed (within 24 hours) by their surgeon or an on-call ophthalmologist with increasing eye redness, pain or decrease in vision (see Table 4 for more details). Primary care practitioners should be aware of postoperative “red flags”.IOL selection evolves out of a comprehensive discussion with the surgeon. Non-MSP covered lenses may lessen dependency on glasses post-surgery, but may not be appropriate for all patients due to individual suitability or side effects. Glasses are usually required after surgery for near and sometimes also distance vision. ![]() Patients can be reassured that MSP-covered monofocal lenses provide fully satisfactory visual correction in the vast majority of patients. IOL technologies and choices continuously evolve as does MSP coverage of IOLs. When a cataract lens is surgically removed, it is replaced with a synthetic intraocular lens (IOL).Cataract surgery may be indicated in other ocular diseases for reasons independent of vision rehabilitation.Indications for cataract surgery are not limited to Snellen visual acuity alone 2 and referral for cataract surgery consultation is indicated in the setting of glare, monocular diplopia or other non-visual functional impairment.Patients who are long-term users of corticosteroids (by any route) should be informed of the increased risk of cataract formation.Safety eyeglasses during high-risk activities at work or recreation to avoid eye trauma.Reduced ultraviolet (UV) -B exposure (hats, sunglasses with UV-B protection).The following are recommended to delay the onset and progression of cataracts: 1,2.This guideline provides recommendations to primary care practitioners for the prevention, diagnosis, management and postoperative care of cataracts in adults (age 19 and older). Effective Date: Recommendations and Topics ![]()
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