Cataract

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Cataract is defined as opacity of the lens. Causes may be classified as acquired and congenital. Aging, trauma, inflammation, drugs and metabolic disorders like diabetes mellitus are the leading causes while intrauterine infections, inheritance and congenital abnormalities are the leading congenital causes of cataracts. Treatment for cataract is surgical except for galactocaemic cataract which reverses when the neonate is given a lactose free diet. Cataract present with a white pupil in children, loss of vision of various degrees, squint and rarely painful blind eye if neglected and complicated with glaucoma and lens induced uveitis. 

Mydriatic Drugs

 

Medicine

Dose

Frequency

Duration

 

tropicamide 0.5% or 1% eye drops

1-3 drops

stat

pre op

or

cyclopentolate 0.5% or 1% eye drops

1-3 drops

stat

pre-op

and

phenylephrine 2.5% eye drops

1-3 drops

stat

pre-op

 

atropine 0.5 or 1%

1-2 drops

2-3 times/day

1 week

Corticosteroid drugs used post cataract surgery:

 

Medicine

Dose

Frequency

Duration

 

dexamethasone 0.1% neomycin 0.35% , polymyxin B sulphate 6000units/L and ointment

1 drop

6 hourly

6 weeks

or

dexamethasone 0.1% neomycin 0.35% eye drops and ointment

1 drop

6 hourly

6 weeks

or

betamethasone 0.1% eye drops

1 drop

6 hourly

6 weeks

 

prednisolone acetate 1% eye drops

1 drop

1-2 hourly

2-3 weeks

Antibacterial drugs for eye infections

 

Medicine

Dose

Frequency

Duration

 

gentamicin 0.3% eye drops

1 drop

2-6 hourly

14 days

or

ciprofloxacin 0.3% eye drops

1 drop

1-2 hourly

2 days then reduce dose to 4 hourly for 12 days

or

ofloxacin 0.3% eye drops

1 drop

2-4 hourly

2 days then reduce to 4 hourly for 10 days

 

Antiviral agents for eyes

 

Medicine

Dose

Frequency

Duration

 

acyclovir eye ointment (for corneal ulcers)

1cm ointment

5 times a day

14 days

 

acyclovir 200mg tablet (for Herpes zoster ophthalmicus)

800mg

5 times a day

7 days

or

famciclovir 250mg tablet (for Herpes zoster ophthalmicus)

500mg

3 times/day

7 days

Treatment for Cytomegalovirus retinitis 

 

Medicine

Dose

Frequency

Duration

 

ganciclovir 500mg vial

5mg/kg infusion

12 hourly

14-21 days

and

foscarnet 24mg/ml IVI

90mg/kg infusion

12 hourly

2-3 weeks

Topical anaesthetics and diagnostic preparations:

 

Medicine

Dose

Frequency

Duration

 

oxybuprocaine hydrochloride 0.4% eye drops

1 drop

stat

repeat if necessary

or

tetracaine hydrochloride 0.5% eye drops

1 drop

stat

repeat if necessary

Diagnostic preparations

Medicine

Dose

Frequency

Duration

fluorescein strips

1 strip

single use

single use

fluorescein solution 1% or 2%

1 vial

single use

single use