Management of the Patient with Cataract
The problem of what to do for the patient with cataract is not always easy to solve and usually it is of considerable importance to the happiness and welfare of the patient. Naturally, the individual wishes to know the cause for the gradual loss of vision. Since cataracts often occur in patients outside the age limits of the senile group, another cause must be found in many instances.
It has been our experience that, after those changes in youngsters and young adults up to 40 years of age have been classified as hereditary, traumatic, or uveal, as the case may be, cataracts coming on in the next twenty years—from 40 to 60 years of age—usually are due to other causes.
The group of hereditary causes have all been classified and taken care of. Those due to trauma definitely become fewer in number but several new types appear. First, a group of early lens changes are seen in women who have had disturbances of the endocrine glands. These are not necessarily limited to those patients who have had thyroidectomies and postoperative tetany, but there is a fair number of patients who have a mild form of hypoparathyroidism with definite lens changes. These patients may complain of recurrent ocular pain and transitory blurring of vision which is a forerunner of more definite changes. As a rule, this is due to a ciliary spasm associated with a mild Chvostek's or with Trousseau's sign. Fortunately, these cases are few in number and. . .