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Last reviewed: 16 Mar 2025
Last updated: 22 Nov 2024

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • subjective decrease in vision
  • blurred or cloudy vision
  • glare
  • washed-out colour vision
  • reduced visual acuity
  • blunted red reflex

Other diagnostic factors

  • inadequate glasses prescription
  • disruption of activities of daily living

Risk factors

  • age >60 years
  • female sex
  • smoking
  • long-term UV exposure
  • diabetes mellitus
  • eye trauma
  • long-term corticosteroid use
  • family history of congenital cataract or congenital influences (e.g., toxins)
  • uveitis
  • myopia
  • other metabolic or hereditary conditions
  • exposure to ionising radiation
  • high body mass index (BMI)

Diagnostic investigations

1st investigations to order

  • dilated fundus examination
  • measurement of intra-ocular pressure
  • glare vision test
  • slit lamp examination of the anterior chamber

Investigations to consider

  • assessment of best visual potential
  • B-scan ultrasonography

Treatment algorithm

Contributors

Authors

Robert T. Chang, MD

Associate Professor of Ophthalmology

Byers Eye Institute

Stanford University School of Medicine

Stanford

CA

Disclosures

RTC declares that he is an ad hoc consulting advisory for Alcon, which makes cataract equipment.

Acknowledgements

Dr Robert T. Chang would like to gratefully acknowledge Dr Creig Hoyt, Dr Leela V. Raju, and Dr M. Bowes Hamill, previous contributors to this topic.

Disclosures

CH, LVR, and MBH declare that they have no competing interests.

Peer reviewers

Michael P. Ehrenhaus, MD

Assistant Professor of Ophthalmology

Cornea External Disease and Refractive Surgery Local Director

Long Island College Hospital Eye Center

Brooklyn

NY

Disclosures

MPE declares that he has no competing interests.

Parwez Hossain, PhD, FRC Ophth, FRCS(Ed)

Associate Professor/Consultant in Ophthalmology

University of Southampton

Southampton

UK

Disclosures

PH declares that he has no competing interests.

Bob Avery, MD, PhD

Assistant Professor

Ophthalmology

University of New Mexico Medical School

Albuquerque

NM

Disclosures

BA declares that he has no competing interests.

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