Cataract: Diagnosis and Treatment

Diagnosis

Ophthalmologists typically diagnose cataracts by directly viewing the opacified layers of the lens with the slit lamp biomicroscope. Cataracts can also be detected with the direct ophthalmoscope. In a room with dim illumination and the focusing dial of the ophthalmoscope set at “0,” the doctor observes the patient at arm’s length. Opacified areas of the lens may appear as silhouettes within the red reflex, or the red reflex may be darker than normal.

Treatment

Treatment is surgical, although use of a long–acting mydriatic drop, such as atropine or homatropine, in patients with early posterior subcapsular cataract can sometimes delay the need for surgery. Cataract extraction involves removal of the lens and possible replacement with an artificial intraocular lens. This surgery is generally elective and should be considered only in people whose vision with the best possible eyeglasses is insufficient to meet their needs.