| What factors should guide the prioritization of care for cataract patients? | the severity of the disease and need for treatment | • Explain implications of associated corneal opacity/glaucoma/uveitis/ retinal disease/optic nerve disease/ amblyopia/squint/uncontrolled systemic disease • Prioritize care according to the severity of the disease and need for treatment • Refer to specialist for consultation/ opinion/management and follow up | 186 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | • Explain implications of associated corneal opacity/glaucoma/uveitis/ retinal disease/optic nerve disease/ amblyopia/squint/uncontrolled systemic disease • Prioritize care according to the severity of the disease and need for treatment • Refer to specialist for consultation/ opinion/management and follow up | 1 | page=1,block=48 | 0.700 | valid |
| Why might cataract surgery be required in cases of narrow angle glaucoma? | to improve control of IOP | Clinically significant cataract causing visual loss enough to warrant surgery (BCVA in affected eye < 6/12 or patient feeling visually handicapped even with BCVA ≥ 6/12). Advanced cataracts with severe visual loss BCVA <6/60 or worse should be operated on priority 2. Clinically significant cataract enough to account for other visually disturbing symptoms such as glare, loss of contrast or polyopia which are bothersome enough for the patient to undergo surgery 3. Significant cataract hampering visualization of fundus for examination or treatment of retinal disorders 4. Cataract with narrow angle glaucoma where cataract surgery is required to improve control of IOP Advice for follow up as needed Discussion with patient about cataract, need for surgery, possible surgical options, expected outcome and prognosis PROCEED FOR SURGERY IF INDICATED INDICATIONS FOR SURGERY | 646 | relationship | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | Cataract with narrow angle glaucoma where cataract surgery is required to improve control of IOP Advice for follow up as needed Discussion with patient about cataract, need for surgery, possible surgical options, expected outcome and prognosis PROCEED FOR SURGERY IF INDICATED INDICATIONS FOR SURGERY |
| What actions should be taken for cataract patients requiring further expertise? | Refer to specialist for consultation/ opinion/management and follow up | • Explain implications of associated corneal opacity/glaucoma/uveitis/ retinal disease/optic nerve disease/ amblyopia/squint/uncontrolled systemic disease • Prioritize care according to the severity of the disease and need for treatment • Refer to specialist for consultation/ opinion/management and follow up | 239 | summary | 0.970 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | • Explain implications of associated corneal opacity/glaucoma/uveitis/ retinal disease/optic nerve disease/ amblyopia/squint/uncontrolled systemic disease • Prioritize care according to the severity of the disease and need for treatment • Refer to specialist for consultation/ opinion/management and follow up | 1 | page=1,block=48 | 0.700 | valid |
| What does CME stand for in the context of ophthalmology? | Cystoid macular edema | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or amblyopia. | 41 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or |
| What does ECCE refer to in cataract surgery terminology? | Extra capsular cataract extraction | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or amblyopia. | 69 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or |
| What does SICS stand for in cataract surgery? | Small incision cataract surgery | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or amblyopia. | 307 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or |
| What is the meaning of IOL in the context of cataract treatment? | Intraocular lens | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or amblyopia. | 134 | definition | 0.940 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | BCVA: Best corrected vbisual acuity CME: Cystoid macular edema ECCE: Extra capsular cataract extraction FBS: Fasting blood sugar IOL: Intraocular lens IOP: Intraocular pressure PCO: Posterior capsular opacification PMMA: Polymethyl methacrylate PPBS: Post prandial blood sugar RBS: Random blood sugar SICS: Small incision cataract surgery VAO: Visual axis opacification * If vision does not improve with refraction, a clinical assessment must be made to assess if this is purely due to cataract, or ocular co-morbidity such as corneal pathology, glaucoma, retinal disease, optic nerve pathology or |
| What are some clinical indications for performing an ultrasound B-scan? | suspected associated vitreous haemorrhage or retinal detachment | Torch, distant direct ophthalmoscopy ESSENTIAL Vision and refraction, intraocular pressure (IOP), slit lamp examination, pupillary reflexes, pressure over lacrimal sac area, fundus examination (if fundus examination is not possible due to dense cataract then ultrasound B-scan is advisable) DESIRABLE Slit lamp-specular reflection, ultrasound-B scan (if there is any clinical indication such as suspected associated vitreous haemorrhage or retinal detachment) LOOK FOR OTHER CAUSES OF VISION IMPAIRMENT AND REFER AS NECESSARY • Corneal pathology • Glaucoma • Retinal disease • Optic nerve disease • Amblyopia ESSENTIAL INVESTIGATIONS • Blood pressure • Blood sugar (FBS, PPBS/RBS) • Ophthalmic biometry (Axial length and keratometry for IOL power calculation) DESIRABLE INVESTIGATIONS • Lacrimal sac syringing • ECG OPTIONAL INVESTIGATIONS • Xylocaine sensitivity test dose if h/o allergy • Specular microscopy • Serology testing** • Other investigations based on existing ocular & systemic disease 1. | 395 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | Torch, distant direct ophthalmoscopy ESSENTIAL Vision and refraction, intraocular pressure (IOP), slit lamp examination, pupillary reflexes, pressure over lacrimal sac area, fundus examination (if fundus examination is not possible due to dense cataract then ultrasound B-scan is advisable) DESIRABLE Slit lamp-specular reflection, ultrasound-B scan (if there is any clinical indication such as suspected associated vitreous haemorrhage or retinal detachment) LOOK FOR OTHER CAUSES OF VISION IMPAIRMENT AND REFER AS NECESSARY • Corneal pathology • Glaucoma • Retinal disease • Optic nerve disease • |
| What are some post-operative complications that require timely referral? | PCO(VAO)/CME/Corneal decompensation/raised intraocular pressure/ uveitis/ displaced IOL/delayed endopthalmitis/ scleritis/ wound dehiscence | PHC/PRIMARY LEVEL • Detailed examination • Refraction for BCVA • Preliminary diagnosis • Referral to Ophthalmologist if BCVA, vision with pinhole ≤ 6/12 • Postoperative follow up and compliance • Timely referral in case of drop in vision or development of fresh symptoms after last follow up visit for post-operative complications such as PCO(VAO)/CME/Corneal decompensation/raised intraocular pressure/ uveitis/ displaced IOL/delayed endopthalmitis/ scleritis/ wound dehiscence etc. | 339 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | PHC/PRIMARY LEVEL • Detailed examination • Refraction for BCVA • Preliminary diagnosis • Referral to Ophthalmologist if BCVA, vision with pinhole ≤ 6/12 • Postoperative follow up and compliance • Timely referral in case of drop in vision or development of fresh symptoms after last follow up visit for post-operative complications such as PCO(VAO)/CME/Corneal decompensation/raised intraocular pressure/ uveitis/ displaced IOL/delayed endopthalmitis/ scleritis/ wound dehiscence etc. |
| What are the indications for urgent referral in cataract patients? | White cataract, shallow AC, sluggish pupil, sudden vision loss with cataract, bilateral advanced cataract | A decision must be taken based on history and clinical features and further referral to higher centre if necessary. • Any patient with cataract and BCVA < 6/12 in better eye qualifies is visually impaired and should be offered surgery. • Patients with cataract and BCVA ≥ 6/12 may also be offered surgery depending on symptoms and visual needs. ** A risk assessment by history and review of any risk factors for possible carrier of transmissible diseases such as HIV/HBsAg/HCV should be done and serology testing may be done if any risk factor is identified. In general, standard universal precautions must be taken in all cases. INDICATIONS FOR URGENT REFERRAL : White cataract, shallow AC, sluggish pupil, sudden vision loss with cataract, bilateral advanced cataract. July/ 2020 | 664 | list | 0.820 | https://www.icmr.gov.in/icmrobject/uploads/STWs/1726569103_cataract.pdf | INDICATIONS FOR URGENT REFERRAL : White cataract, shallow AC, sluggish pupil, sudden vision loss with cataract, bilateral advanced cataract. | 1 | page=1,block=54 |