How should cataracts be measured?

Acquired cataract and cognitive impairment are both common age related problems, and ophthalmologists are increasingly likely to encounter patients who have both. Dementia types which display early visuo-perceptual impairment may present first to ophthalmology services. When these patients have coexisting cataract it may be difficult to distinguish visual complaints due to cataract from those due to dementia.The interaction between visual impairment due to cataract, and neurodegenerative disorders affecting the central visual pathways, is not fully understood. Visual impairment due to cataract may stress impaired attentional mechanisms, and cataract extraction may improve cognitive performance in some patients with early cognitive impairment; however the benefits of cataract surgery in established dementia are less clear. Here we review the literature on this subject and consider the implications for practice.

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“…The pathophysiology and classification of acquired age related cataract have been reviewed elsewhere (e.g. [9, 10])…”

Section: Definitionsmentioning

confidence: 99%

Cataract and cognitive impairment: a review of the literature

Jefferis

Mosimann²,

Clarke³

2010

British Journal of Ophthalmology

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“…A cataract is an increased opacity in the eye's lens as a result of metabolic changes in the lens fibres over time. Cataracts are one of the primary causes of visual impairment and blindness in the world (Monestam & Wachtmeister, ), and population surveys have reported that most senior citizens have some form of cataract (Sparrow & Frost, ). It has been estimated that a cataract affects half of the population by the age of 70 years and the entire population will be affected at the age of 90 years (Monestam & Wachtmeister, ).…”

Section: Introductionmentioning

confidence: 99%

The Eye of the Beholder: A Case Example of Changing Clients' Perspectives Through Involvement in the Model Validation Process

et al. 2015

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Validation is an important topic in the system dynamics field. A large body of knowledge addresses validation tests and procedures. However, the use of validation in practice and its results are scarcely reported. This is surprising as some authors assume that in order to build confidence in a model, it is crucial to at least communicate the validation process and its results. In this paper, we described a validation process in direct interaction with clients. We describe the tests and procedures we employed to iteratively build and validate a simulation model with the National Health Care Institute (The Netherlands) in a group model-building setting. The involvement challenged the clients' opinions and in some cases led to changes in their mental models.

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“…This suggests that an increasing number of patients with early cataract and relatively good visual acuity (VA) are being operated on. Sparrow & Frost (2004) questioned the true need for cataract surgery in the majority of elderly people when they found that the number of cataract operations had increased by 75% between 1997-1998 and 2002-2003 in England and Wales. Rates of cataract surgery in Finland in the 1990s have been reported as high compared with international levels (Kontkanen 2001).…”

Section: Introductionmentioning

confidence: 99%

The Pyhäjärvi Cataract Study. I. Study design, baseline characteristics and the demand for cataract surgery

Falck

Kuoppala

Winblad

et al. 2008

Acta Ophthalmologica

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ABSTRACT.Purpose: The Pyha¨ja¨rvi Cataract Study aims to study demand for cataract surgery in the population of a rural town in Finland. Methods: A random, population-based sample of 881 persons aged ‡ 60 years were interviewed by telephone to obtain a Visual Function-14 (VF-14) score. A total of 294 persons were invited for an ophthalmic examination based on three categories of VF-14 score. Of these, 230 (78%) responded, 10 of whom were excluded as a result of prior bilateral surgery. The New Zealand Priority Criteria (NZPC) and the 15-Dimension Quality of Life (15-D) instruments were administered. In addition, another group of 96 patients waiting for cataract surgery were examined and scored using the VF-14, NZPC and 15-D instruments. A modified Lens Opacities Classification System (LOCS) III classification was used for grading the cataract. Results: Only one (0.5%) of the 220 examined subjects was referred for cataract surgery. Many patients with relatively good visual acuity (VA), including six people with a 100-point VF-14 score suggesting no visual symptoms, were waiting for surgery. Demographic factors were not associated with access to cataract surgery. The patients examined from the waiting list for cataract surgery had more cataractous changes in the lens(es), poorer VA, were older, and scored higher on the NZPC instrument than the population sample examined. Conclusions: Practically no hidden demand for cataract surgery was found in the study population as defined by the national criteria for cataract surgery in Finland. This reflects the fact that the current Finnish health care system appears to recognize and treat cataract patients very well, even in rural areas. Although VA tests may not be sufficient for evaluating need for cataract surgery, the role of questionnaires is not clear either.

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How should cataracts be measured?

Cited by 5 publications

References 15 publications

Cataract and cognitive impairment: a review of the literature

Cataract and cognitive impairment: a review of the literature

The Eye of the Beholder: A Case Example of Changing Clients' Perspectives Through Involvement in the Model Validation Process

The Pyhäjärvi Cataract Study. I. Study design, baseline characteristics and the demand for cataract surgery

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