By American Academy of Ophthalmology, James C. Bobrow MD
Studies the anatomy, body structure, embryology and pathology of the lens. Covers the epidemiology, overview and administration of cataracts and provides an summary of lens and cataract surgical procedure, together with specified events. part eleven additionally walks the reader via making a suitable differential analysis and designing a administration plan for intraoperative and postoperative issues of cataract surgery.
Upon final touch of part eleven, readers might be capable to:
Identify congenital anomalies of the lens
List sorts of congenital and bought cataracts
Describe the organization of cataracts with getting older, trauma, medicines, and systemic and ocular diseases
Describe the assessment and administration of sufferers with cataract and different lens abnormalities
Read or Download 2014-2015 Basic and Clinical Science Course (BCSC): Section 11: Lens and Cataract PDF
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Additional resources for 2014-2015 Basic and Clinical Science Course (BCSC): Section 11: Lens and Cataract
B, Subluxated lens in Marfan syndrome . (Part A courtesy of Karla J. ) Figure 3-15 ,.. • CHA PTER 3: Embryology and Developmental Defects • 37 • Spectacle or contact lens correction of the refractive error provides satisfactory visual acuity in most cases. Pupillary dilation is sometimes helpful. The clinician may refract both the phakic and the aphakic portions of the pupil to determine the optimum visual acuity. A reading add is often necessary because the subluxated lens lacks sufficient accommodation.
Approximately 5% of lens glucose is metabolized by this route, although the pathway is stimulated in the presence of elevated levels of glucose. HMP shunt activity is higher in the lens than in most tissues, but the role of the HMP shunt is far from established. As in other tissues, the HMP shunt may provide NADPH (the reduced form of nicotinamide adenine dinucleotide phosphate [NADP]) for fatty acid biosynthesis and ribose for nucleotide biosynthesis. It does provide the NADPH necessary for glutathione reductase and aldose reductase activities in the lens.
The Michaelis constant (Km) of aldose reductase for glucose is approximately 700 times that for hexokinase. Because the affinity is actually the inverse of Km, aldose reductase has a very low affinity for glucose compared to hexokinase. Less than 4% of lens glucose is normally converted to sorbitol. As previously noted, the hexokinase reaction is rate-limited in phosphorylating glucose in the lens and is inhibited by the feedback mechanisms of the products of glycolysis. Therefore, when glucose increases in the lens, as occurs in hyperglycemic states, the sorbitol pathway is activated relatively more than the glycolytic pathway; and sorbitol accumulates.