Investigations
1st investigations to order
dilated fundus examination
Test
Ophthalmoscopy is performed following pupillary dilation.
Where the cataract is a significant cause of the patient's visual loss, fundus examination and the optic nerve should appear normal.
Result
fundus and optic nerve normal
measurement of intra-ocular pressure
Test
Performed as part of the initial ophthalmology assessment.[35]
Result
normal, or may be elevated if associated glaucoma
glare vision test
Test
Vision is checked using the best-corrected spectacle prescription and a formal eye chart.[35]
Glare stress is induced using the brightness acuity tester, a hand-held instrument with an illuminated field pierced with a viewing aperture. This instrument allows the examiner to measure the patient's visual acuity under glare conditions that the patient might experience in the real world.
Result
significant cataract: reduced visual acuity under the conditions of glare stress
slit lamp examination of the anterior chamber
Investigations to consider
assessment of best visual potential
Test
It is important to assess best visual potential before commencing cataract surgery. This may involve pinhole acuity potential, potential acuity meter, or a macular optical coherence tomography imaging test.
Result
variable
B-scan ultrasonography
Test
View of the posterior pole may be compromised in a patient with dense cataract. Ultrasound is performed to assess gross retinal and vitreous status.
Result
normal; may occasionally detect pathology that influences surgical strategy
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