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Cataract

Definition

The cataract is an eye disease characterised by a cloudiness of the normally transparent crystalline lens. It may affect the entire crystalline lens or only a specific part, such as the anterior capsule, the posterior capsule, the crystalline cortex, or the crystalline core. As the disease progresses, the cataract may lead to a reduction of visual acuity.

Note:
The crystalline lens is composed of a transparent gel and surrounded by a capsule. It lies behind the posterior face of the iris and in front of the vitreous body. The crystalline lens plays an important role in the process of accommodation, which allows us to see clearly both close-up and at a distance. Furthermore, the crystalline lens focuses light rays onto the retina in the back of the eye. There, they are converted to electrical signals which are they transferred to the brain via the optic nerve. In patients suffering from a cataract, the cloudiness of the crystalline lens may compromise these functions.


In certain cases, the posterior crystalline capsule becomes cloudy again several months or years after extra-capsular cataract extraction, the initial cataract surgery. This new opacification is called a secondary cataract. It develops gradually and progressively with time and generally occurrs between 3 months and 4 years after the initial surgical intervention.1 Symptoms are similar to the primary cataract symptoms described in this chapter. Sessions of laser treatment are the foundation of secondary cataract treatment.

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Epidemiology

Cataracts are very common in the elderly. In the United Kingdom, 2.4 million English and Welsh subjects suffer from cataracts.2 In France, around 20% of people older than 65 years of age, 35% of those older than 75, and more than 60% of those older than 85 are affected3 . In Canada, 12% of people aged 65-69 years and 28% of people older than 80 years suffer from cataracts.4 Among Belgians aged 65 years or older, 6.2% of men and 12.2% of women present this condition.5 Due to the increase in life expectancy, frequency rates of cataracts are on the rise.

2 The Royal College of Ophthalmologists. Cataract surgery guidelines 2004. p. 6.
3 ANAES. Evaluation du traitement chirurgical de la cataracte de l’adulte. Février 2000. p. 4.
4 Millar WJ. Problèmes de vision chez les personnes âgées. Dans: Rapports sur la santé. Volume 16 n°1. Statistique Canada. 2004. p. 49-54.
5 Institut Scientifique de la Santé Publique. Enquête de santé par interview Belgique 2004. Livre II - Chapitre 2: Maladies et affections chroniques. 2006. p. 66-7.

 

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