2014-2015 Basic and Clinical Science Course (BCSC): Section by American Academy of Ophthalmology, James C. Bobrow MD

By American Academy of Ophthalmology, James C. Bobrow MD

Reports the anatomy, body structure, embryology and pathology of the lens. Covers the epidemiology, overview and administration of cataracts and provides an outline of lens and cataract surgical procedure, together with particular events. part eleven additionally walks the reader via making a suitable differential analysis and designing a administration plan for intraoperative and postoperative problems of cataract surgery.

Upon final touch of part eleven, readers might be capable to:

Identify congenital anomalies of the lens
List varieties of congenital and bought cataracts
Describe the organization of cataracts with getting older, trauma, medicinal drugs, and systemic and ocular diseases
Describe the review and administration of sufferers with cataract and different lens abnormalities

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Extra info for 2014-2015 Basic and Clinical Science Course (BCSC): Section 11: Lens and Cataract

Example text

As in other tissues, the HMP shunt may provide NADPH (the reduced form of nicotinamide adenine dinucleotide phosphate [NADP]) for fatty acid biosynthesis and ribose for nucleotide biosynthesis. It does provide the NADPH necessary for glutathione reductase and aldose reductase activities in the lens. The carbohydrate products of the HMP shunt enter the glycolytic pathway and are metabolized to lactate. The glucose that is not phosphorylated to G6P enters the sorbitol pathway, which is yet another pathway for lens glucose metabolism, or it is converted into gluconic acid.

Tunica Vasculosa Lentis At about 1 month of gestation, the hyaloid artery, which enters the eye at the optic disc, branches to form a network of capillaries, the tunica vasculosa lentis, on the posterior surface of the lens capsule (Fig 3-3). These capillaries grow toward the equator of the lens, where they anastomose with a second network of capillaries, called the anterior pupillary membrane, which derives from the ciliary veins and which covers the anterior surface of the lens. At approximately 9 weeks' gestation, the capillary network surrounding the lens is fully developed; it disappears by an orderly process of programmed cell death shortly before birth.

Nuclear cataracts typically cause greater impairment of distance vision than of near vision. In the early stages, the progressive hardening of the lens nucleus frequently causes an increase in the refractive index of the lens and thus a myopic shift in refraction (lenticular myopia). In hyperopic eyes, the myopic shift enables otherwise presbyopic individuals to read without spectacles, a condition referred to as second sight. Occasionally, the abrupt change in refractive index between the sclerotic nucleus (or other 39 b 40 • Lens and Cataract • A B D E G H J K C L Figure 4-1 Increasing yellow-to-brown coloration of the human lens from 6 months (A) through 8 years (B), 12 years (C), 25 years (0), 47 years (E), 60 years (F), 70 years (G), 82 years (H), and 91 years (/} .

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