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Eye complaints and vasculitis: CataractThis lecture was given in Bruges, by Dr B. Heintz, ophthalmologist in the Elisabeth Hospital in Sijsele-Damme
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| What is cataract? |
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Cataract is a clouding of the lens in the eye. It can have different causes but usually it is associated with the natural ageing process. It can also occur after taking corticosteroids or it can develop due to diabetes.
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| What are the consequences of cataract? |
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The light rays entering the eye have to go through the opaque lens and reach the retina with difficulty. That is why typical symptoms, like a gradual blurring of vision, develop.
Especially the long-sightedness is reduced. Reading is mostly not a problem.
If the clouding is more serious at certain spots, complaints of double vision and increased sensitivity to light occur.
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| How can cataract be treated? |
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Treatment is always surgical. The most recent (and widespread) technique is called the 'phacoemulsification'. In this procedure the surgeon makes an incision in the lens covering, breaks up the lens, sucks up the lens fragments and places an intraocular lens implant. The patient only has to stay in the hospital for one day at the most. Thanks to this procedure the incision heals quickly. The procedure is performed under local anaesthesia.
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| What is cataract caused by the intake of corticosteroids?? |
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The development of this type of cataract is different. Due to corticosteroids minuscule crystals stick to the back of the lens. If the entering light falls into these crystals, it is reflected in all directions and multiplied. A patient with these symptoms is likely to close the curtains when light enters a room, and is easily blinded by sunlight and approaching cars. The symptoms of cataract caused by corticosteroids are basically sensitivity to light, together with a reduced vision outdoors. The treatment is the same as in the common form of cataract.
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| I was treated with a laser for a retinal tear. Now I am diagnosed with cataract. Is there a connection? |
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A very serious laser treatment could possibly cause cataract, but the treatment of a retinal tear does not.
Round the horseshoe-shaped tear some tens of laser dots (=small burns) are applied in 2 to 3 rows to fix the retina around the tear to the underlying layers, to prevent the surrounding retina to come loose. The lens remains untouched, so again the cataract occurs as a normal ageing process in the eye. It is necessary to treat a retinal tear immediately to prevent the detachment of the retina due to fluid under it.
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| I am a Sjogren patient and since I was a child I have been extremely sensitive to sunlight. Is there an explanation? |
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The retina contains little rods and cones that convert the light signals into electrical messages that are transmitted by the optic nerve to the brain. These small cells are protected by a pigment (like our skin). A high degree of pigment provides a good protection, while a small amount of pigment causes blinding. For this problem, reliable sunglasses may offer a solution.
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 Also read: Eye complaints and vasculitis: GlaucomaBack to Articles
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