Ingris 3 the Correlatiuon Between DM and Cataract

8/6/2019 Ingris 3 the Correlatiuon Between DM and Cataract

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The Correlation Between Diabetes Mellitus and Cataract

FACULTY OF MEDICINE TRISAKTI UNIVERSITY

JAKARTA 2011

NAME : FERIO JOELIAN


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Student Number : 030 05 095

PREFACE

This paper, titled The Correlation Between Diabetes Mellitus and Cataract .

The writer made this paper to complete the English assignment for 3 rd Medical

English subject in Faculty of Medicine, Trisakti University.

The writer arranged this paper by searching the information from textbook and

internet. The Writer managed the structure for this topic to be simple and easier for

all the readers to understand. The writer hopes this papers topic is compatible and

can give the information which needed by anyone, such as medical student and

physicians, both here and abroad.

The writer realized that this paper probably need to be corrected. For that

reason, critics and suggestions will be accepted as long as it improves the writer. The

writer hopes all the readers who had read this paper will continue to find out deeply

about this topic. As the result, their knowledge will develop not only from this paper,

but also from other sources.

The writer would like to say thanks to dr. Alvina as the lecturer, who had been

very kind and patient to taught and helped in finishing this paper. Furthermore, a big

thanks also delivered to the writers parents, friends and everybody who have helped

and inspired the writer during the process of making this paper. Finally, The writer

hopes this paper will be useble for the us.

Thank you.

Jakarta, July 2011

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Ferio Joelian

CONTENTS

Cover

Preface

Contents

Abstract

Chapter I : Introduction

1.1 Backgrounds

1.2 Problems

1.3 Limitations of Problems

1.4 Objectives

1.5 Method of Writing

1.6 Frame of Writing

Chapter II : Diabetes Mellitus

Chapter III : Cataract

Chapter IV : Cervical Cancer and Human Papillomavirus

Chapter V : Conclusion

References

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ABSTRACT

Diabetes mellitus is a disease that can increase the blood glucose levels. As a

metabolic disease, diabetes mellitus can damage and influence other organ in the

body. Cataract is a a clouding of the lens in eyes and can affects the vision. Cataract is

very common in older people, but it can be a complication from other diseases.

In many cases, people may not realize about their abnormality glucose levels

in blood. Diabetes affects approximately 17 million people (about 8% of the

population) in the United States. In addition, an estimated additional more than 12

million people have diabetes and don't even know it. And they realize it after the

complications of this disease appears.

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CHAPTER I

INTRODUCTION

I.1 Background(1), (2)

Diabetes Mellitus is a set of related diseases in which the body cannot regulate

the amount of sugar (specifically, glucose) in the blood that can make the normal

blood vessels become abnormal and can damage other organs.(1)

Cataract is a abnormallity of the lens eyes, it can be normal in older people or

can be the complication from other diseases, such as diabetes mellitus.

Over time, diabetes can lead to blindness, kidney failure, and nerve damage.

These types of damage are the result of damage to small vessels, referred to as

microvascular disease. Diabetes is also an important factor in accelerating the

hardening and narrowing of the arteries (atherosclerosis), leading to strokes, coronary

heart disease, other large blood vessel diseases, and eyes specially cataract.(2)

For that reason, I choose this topic as my title in English paper. So I can

acknowledge about it.

I. 2 Problems

The main problem that will be discussed in this paper is about the connection

between Diabetes Mellitus and Cataract. And hopefully, the writer can figure it out

about the connection for both of them.

I. 3 Limitations of Problems

The writer makes the limitation about what kind of sub-subject should The

writer discuss here to prevent the discussion to be over detail. The limitations of the

problems are definition, types, etiology, symptoms, diagnose, preventions and the

treatments. The writer also add some extra information needed, but the aim of the

explanation is the correlation between the problems.

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I.4 Objectives

The objective of this paper is to inform the reader more information about the

correlation between Diabetes Mellitus and Cataract. For that, the writer hopes the

readers awareness to make it develop. Further purpose is the prevention of these

diseases can be done perfectly.

I. 5 Method of Writing

The method that The writer uses to make this paper based on the rules which

given from the institude. The writer got the information by collecting data from many

kinds of sources, there are books, journals and internet.


Chapter 1: Introduction

1.1 Backgrounds

1.2 Problems

1.3 Limitations of Problems

1.4 Objectives

1.5 Method of Writing


Chapter 2: The Correlation between Diabetes Mellitus and Cataract

Chapter 3: Conclusion

References

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CHAPTER II

DIABETES MELLITUS

Diabetes mellitus is a group of metabolic diseases characterized by high blood

glucose levels, that result from defects in insulin secretion, or action, or both.

Diabetes mellitus, commonly referred to as diabetes was first identified as a disease

associated with "sweet urine," and excessive muscle loss in the ancient world.

Elevated levels of blood glucose (hyperglycemia) lead to spillage of glucose into the

urine, hence the term sweet urine.

Normally, blood glucose levels are tightly is regulated by several hormones,

including insulin. Insulin is produced by the pancreas, a small organ between the

stomach and liver. The pancreas secretes other important enzymes that help to digest

food. Insulin lowers the blood glucose level. When the blood glucose elevates (for

example, after eating food), insulin is released from the pancreas to normalize the

glucose level. (2)

In patients with diabetes, do not produce enough insulin (type 1 diabetes) or

cannot use insulin properly (type 2 diabetes), or both (which occurs with several

forms of diabetes). In diabetes, glucose in the blood cannot move into cells, so it stays

in the blood. This not only harms the cells that need the glucose for fuel, but also

harms certain organs and tissues exposed to the high glucose levels.the absence or

insufficient production of insulin causes hyperglycemia. Diabetes is a chronic medical

condition, meaning that although it can be controlled, it lasts a lifetime. (2), (3)

II. Types of Diabetes Mellitus (1), (2), (3)

Type 1 diabetes, in this type the body stops producing insulin or produces too

little insulin to regulate blood glucose level. This type is typically recognized in

childhood or adolescence. It used to be known as juvenile-onset diabetes or insulin-

dependent diabetes mellitus.Type 1 diabetes can occur in an older individual due to

destruction of pancreas by alcohol, disease, or removal by surgery. It also results from

progressive failure of the pancreatic beta cells, which produce insulin. People with

type 1 diabetes require daily insulin treatment to sustain life.(1), (2)

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Type 2 diabetes, in this type the pancreas secretes insulin, but the body is

partially or completely unable to use the insulin. This is sometimes referred to as

insulin resistance. The body tries to overcome this resistance by secreting more and

more insulin. People with insulin resistance develop type 2 diabetes when they do not

continue to secrete enough insulin to cope with the higher demands. At least 90% of

patients with diabetes have type 2 diabetes. Type 2 diabetes is typically recognized in

adulthood, usually after age 45 years. It used to be called adult-onset diabetes

mellitus, or non-insulin-dependent diabetes mellitus. These names are no longer used

because type 2 diabetes does occur in younger people, and some people with type 2

diabetes need to use insulin.Type 2 diabetes is usually controlled with diet, weight

loss, exercise, and oral medications. More than half of all people with type 2 diabetes

require insulin to control their blood sugar levels at some point in the course of their

illness. (1), (2), (3)

Gestational diabetes is a form of diabetes that occurs during the second half of

pregnancy.Although gestational diabetes typically goes away after delivery of the

baby. Women who have gestational diabetes are more likely than other women to

develop type 2 diabetes later in life.Women with gestational diabetes are more likely

to have large babies. (1)

III. The Signs and Symptoms (1), (2)

There are some common signs and symptoms that can be found in patient with

diabetes mellitus, such as:

Unexplained weight loss: People with diabetes are unable to process many of

the calories in the foods they eat. Thus, they may lose weight even though theyeat an apparently appropriate or even excessive amount of food. Losing sugar

and water in the urine and the accompanying dehydration also contributes to

weight loss.

Excessive thirst (polydipsia): A person with diabetes develops high blood

sugar levels, which overwhelms the kidney's ability to reabsorb the sugar as

the blood is filtered to make urine. Excessive urine is made as the kidney spills

the excess sugar. The body tries to counteract this by sending a signal to the

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brain to dilute the blood, which translates into thirst. The body encourages

more water consumption to dilute the high blood sugar back to normal levels

and to compensate for the water lost by excessive urination.

Excessive urination (polyuria): Another way the body tries to get rid of the

extra sugar in the blood is to excrete it in the urine. This can also lead to

dehydration because excreting the sugar carries a large amount of water out of

the body along with it.

Excessive eating (polyphagia): If the body is able, it will secrete more insulin

in order to try to deal with the excessive blood sugar levels. Moreover, the

body is resistant to the action of insulin in type 2 diabetes. One of the

functions of insulin is to stimulate hunger. Therefore, higher insulin levels

lead to increased hunger and eating. Despite increased caloric intake, the

person may gain very little weight and may even lose weight.

Poor wound healing: High blood sugar levels prevent white blood cells, which

are important in defending the body against bacteria and also in cleaning up

dead tissue and cells, from functioning normally. When these cells do not

function properly, wounds take much longer to heal and become infected more

frequently. Also, long-standing diabetes is associated with thickening of blood

vessels, which prevents good circulation including the delivery of enough

oxygen and other nutrients to body tissues.

Infections: Certain infection syndromes, such as frequent yeast infections of

the genitals, skin infections, and frequent urinary tract infections, may result

from suppression of the immune system by diabetes and by the presence of

glucose in the tissues, which allows bacteria to grow well. It can also be an

indicator of poor blood sugar control in a person known to have diabetes.

Altered mental status: Agitation, unexplained irritability, inattention, extreme

lethargy, or confusion can all be signs of very high blood sugar, ketoacidosis,

hyperosmolar hyperglycemia nonketotic syndrome, or hypoglycemia (low

sugar).

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Blurry vision: Blurry vision is not specific for diabetes but is frequently

present with high blood sugar levels.

Symptoms of type 1 diabetes are often dramatic and come on very suddenly.

Type I diabetes is usually recognized in childhood or early adolescence, often in

association with an illness (such as a virus or urinary tract infection) or injury.The

extra stress can cause diabetic ketoacidosis.Symptoms of ketoacidosis include nausea

and vomiting. Dehydration and often-serious disturbances in blood levels of

potassium follow.

Symptoms of type 2 diabetes are often subtle and may be attributed to aging or

obesity.A person may have type 2 diabetes for many years without knowing it.Peoplewith type II diabetes can develop hyperglycemic hyperosmolar nonketotic syndrome.

Type II diabetes can be precipitated by steroids and stress.If not properly treated, type

2 diabetes can lead to complications like blindness, kidney failure, heart disease, and

nerve damage.

IV. The Exams and Tests (1)

There are some method to diagnose diabetes mellitus, such as Finger stick

blood glucose. This is a rapid screening test that may be performed anywhere,

including community-based screening programs. A fingerstick blood glucose test is

not as accurate as testing the patient's blood in the laboratory but is easy to perform,

and the result is available right away. The test involves sticking the patient's finger for

a blood sample, which is then placed on a strip. The strip goes into a machine that

reads the blood sugar level. These machines are only accurate to within about 10% of

true actual laboratory values. Fingerstick blood glucose values may be inaccurate atvery high or very low levels, so this test is only a preliminary screening study. This is

the way most people with diabetes monitor their blood sugar levels at home.

A random blood glucose testcan also be used to diagnose diabetes, but the

fasting blood glucose test is more accurate than a random blodd glucose test.. A blood

glucose level of 200 mg/dl or higher indicates diabetes.

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Now, the doctors prefer to choosefasting blood glucose (sugar) testbecause

this test is more accurate than Finger stick test and random blood glucose. It is easy to

perform and convenient. After the person has fasted overnight (at least 8 hours), a

single sample of blood is drawn and sent to the laboratory for analysis. Normal fasting

plasma glucose levels are less than 100 milligrams per deciliter (mg/dl). Fasting

plasma glucose levels of more than 126 mg/dl on two or more tests on different days

indicate diabetes.

When fasting blood glucose stays above 100mg/dl, but in the range of 100-

126mg/dl, this is known as impaired fasting glucose (IFG). While patients with IFG

do not have the diagnosis of diabetes, this condition carries with it its own risks and

concerns, and is addressed elsewhere.

Though not routinely used anymore, the oral glucose tolerance test (OGTT) is

a gold standard for making the diagnosis of type 2 diabetes. It is still commonly used

for diagnosing gestational diabetes and in conditions of pre-diabetes. With an oral

glucose tolerance test, the person fasts overnight (at least eight but not more than 16

hours). Then first, the fasting plasma glucose is tested. After this test, the person

receives 75 grams of glucose (100 grams for pregnant women). There are several

methods employed by obstetricians to do this test, but the one described here is

standard. Usually, the glucose is in a sweet-tasting liquid that the person drinks. Blood

samples are taken at specific intervals to measure the blood glucose. For the test to

give reliable results:

The person must be in good health (not have any other illnesses, not even a

cold).

The person should be normally active (not lying down, for example, as an

inpatient in a hospital), and

The person should not be taking medicines that could affect the blood glucose.

For three days before the test, the person should have eaten a diet high in

carbohydrates (200-300 grams per day).

The morning of the test, the person should not smoke or drink coffee.

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People with glucose levels between normal and diabetic have impaired

glucose tolerance (IGT). People with impaired glucose tolerance do not have diabetes,

but are at high risk forprogressing to diabetes. Weight loss and exercise may help

people with impaired glucose tolerance return their glucose levels to normal. In

addition, some physicians advocate the use of medications, such as metformin

(Glucophage), to help prevent/delay the onset of overt diabetes.

Recent studies have shown that impaired glucose tolerance itself may be a risk

factor for the development of heart disease. In the medical community, most

physicians are now understanding that impaired glucose tolerance is not simply a

precursorof diabetes, but is its own clinical disease entity that requires treatment and

monitoring. Glucose tolerance tests may lead to one of the following diagnoses:

Normal response: A person is said to have a normal response when the 2-hour

glucose level is less than 140 mg/dl, and all values between 0 and 2 hours are

less than 200 mg/dl.

Impaired glucose tolerance: A person is said to have impaired glucose

tolerance when the fasting plasma glucose is less than 126 mg/dl and the 2-

hour glucose level is between 140 and 199 mg/dl.

Diabetes: A person has diabetes when two diagnostic tests done on different

days show that the blood glucose level is high.

Gestational diabetes: A woman has gestational diabetes when she has any two

of the following: a 100g OGTT, a fasting plasma glucose of more than 95

mg/dl, a 1-hour glucose level of more than 180 mg/dl, a 2-hour glucose level

of more than 155 mg/dl, or a 3-hour glucose level of more than 140 mg/dl.

V. Complications (1), (2)

There are two phase of diabetes complication, acute phase and chronic phase.

In the short run, diabetes can contribute to a number of acute (short-lived) medical

problems.

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Many infections are associated with diabetes, and infections are frequently

more dangerous in someone with diabetes because the body's normal ability to

fight infections is impaired. To compound the problem, infections may worsen

glucose control, which further delays recovery from infection.

Hypoglycemia, or low blood sugar, occurs from time to time in most people

with diabetes. It results from taking too much diabetes medication or insulin

(sometimes called an insulin reaction), missing a meal, doing more exercise

than usual, drinking too much alcohol, or taking certain medications for other

conditions. It is very important to recognize hypoglycemia and be prepared to

treat it at all times. Headache, feeling dizzy, poor concentration, tremors of

hands, and sweating are common symptoms of hypoglycemia. You can faint

or have a seizure if blood sugar level gets too low.

Diabetic ketoacidosis is a serious condition in which uncontrolled

hyperglycemia (usually due to complete lack of insulin or a relative deficiency

of insulin) over time creates a buildup in the blood of acidic waste products

called ketones. High levels of ketones can be very harmful. This typically

happens to people with type 1 diabetes who do not have good blood glucose

control. Diabetic ketoacidosis can be precipitated by infection, stress, trauma,

missing medications like insulin, or medical emergencies like stroke and heart

attack.

Hyperosmolar hyperglycemic nonketotic syndrome is a serious condition in

which the blood sugar level gets very high. The body tries to get rid of the

excess blood sugar by eliminating it in the urine. This increases the amount of

urine significantly and often leads to dehydration so severe that it can causeseizures, coma, and even death. This syndrome typically occurs in people with

type 2 diabetes who are not controlling their blood sugar levels, who have

become dehydrated, or who have stress, injury, stroke, or are taking certain

medications, like steroids.

In chronic phase, the blood glucose in diabetes influence the large vessel

disease involving the heart and blood vessels (macrovascular disease). Diabetes

accelerates hardening of the arteries (atherosclerosis) of the larger blood vessels,

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leading to coronary heart disease (angina or heart attack), strokes, and pain in the

lower extremities because of lack of blood supply (claudication).

Beside attack the large blood vessels, the diabetes can attack the small one,

too, that can be damaged the eyes, kidneys and nerves system The major eye

complication of diabetes is called diabetic retinopathy. Diabetic retinopathy occurs in

patients who have had diabetes for at least five years. Diseased small blood vessels in

the back of the eye cause the leakage of protein and blood in the retina. Disease in

these blood vessels also causes the formation of small aneurysms (microaneurysms),

and new but brittle blood vessels (neovascularization). Spontaneous bleeding from the

new and brittle blood vessels can lead to retinal scarring and retinal detachment, thus

impairing vision. Cataracts and glaucoma are also more common among diabetics. It

is also important to note that since the lens of the eye lets water through, if blood

sugar concentrations vary a lot, the lens of the eye will shrink and swell with fluid

accordingly. As a result, blurry vision is very common in poorly controlled diabetes.

Patients are usually discouraged from getting a new eyeglass prescription until their

blood sugar is controlled. This allows for a more accurate assessment of what kind of

glasses prescription is required.

Kidney damage from diabetes is called diabetic nephropathy. The onset of

kidney disease and its progression is extremely variable. Initially, diseased small

blood vessels in the kidneys cause the leakage of protein in the urine. Later on, the

kidneys lose their ability to cleanse and filter blood. The accumulation of toxic waste

products in the blood leads to the need fordialysis. Dialysis involves using a machine

that serves the function of the kidney by filtering and cleaning the blood. In patients

who do not want to undergo chronic dialysis, kidney transplantation can be

considered.

Nerve damage from diabetes is called diabetic neuropathy and is also caused

by disease of small blood vessels. In essence, the blood flow to the nerves is limited,

leaving the nerves without blood flow, and they get damaged or die as a result (a term

known as ischemia). Symptoms of diabetic nerve damage include numbness, burning,

and aching of the feet and lower extremities. When the nerve disease causes a

complete loss of sensation in the feet, patients may not be aware of injuries to the feet,

and fail to properly protect them. Shoes or other protection should be worn as much as

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possible. Seemingly minor skin injuries should be attended to promptly to avoid

serious infections. Because of poor blood circulation, diabetic foot injuries may not

heal. Sometimes, minor foot injuries can lead to serious infection, ulcers, and even

gangrene, necessitating surgical amputation of toes, feet, and other infected parts.

Diabetic nerve damage can affect the nerves that are important for penile erection,

causing erectile dysfunction (ED, impotence). Erectile dysfunction can also be caused

by poor blood flow to the penis from diabetic blood vessel disease. Diabetic

neuropathy can also affect nerves to the stomach and intestines, causing nausea,

weight loss, diarrhea, and other symptoms ofgastroparesis (delayed emptying of food

contents from the stomach into the intestines, due to ineffective contraction of the

stomach muscles).

VI. Prevention and Treatment (1), (2), (3)

To prevet the diabetes mellitus, there is some way to modified the life-style.

But until now, belum ditemuan cara to prevent type 1 diabetes mellitus. Type 2

diabetes, however, can be prevented in some cases.

Control weight to normal or near-normal levels by eating a healthy low-fat,

high-fiber diet.

Regular exercise is crucial to the prevention of type 2 diabetes.

Keep alcohol consumption low.

Quit smoking.

If the person have high blood fat levels (such as high cholesterol) or high

blood pressure, take the medication as directed.

Lifestyle modification and/or certain medications can be used in people with

prediabetes to prevent progression to diabetes. Pre-diabetes can be diagnosed

by checking fasting glucose and two hours after ingesting 75 grams of

glucose.

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If the person already have diabetes, the focus should be on preventing the

complications, which can cause serious disabilities such as blindness, kidney failure

requiring dialysis, amputation, or even death.

Tight glucose control: The single best thing the patient can do is to keep their

blood sugar level within the suggested range every day. The only way to do

this is through a combination of regular blood sugar checks, a balanced diet

low in simple sugars and fat and high in complex carbohydrates and fiber, and

appropriate medical treatment. Please consult a nutritionist or check with the

doctor with questions in regard to diet.

Maintain a healthy weight and quit smoking.

Increase physical activity levels. Aim for moderately vigorous physical

activity for at least 30 minutes every day.

Drink an adequate amount of water and avoid taking too much salt.

The skin should be taken care of; keep it supple and hydrated to avoid sores

and cracks that can become severely infected.

Brush and floss the teeth every day. See a dentist regularly to prevent gum

disease.

The feet should be washed and examined daily, looking for small cuts, sores,

or blisters that may cause problems later. The toenails should be filed rather

than cut to avoid damaging the surrounding skin. A specialist in foot care

(podiatrist) may be necessary to help care for the feet.

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CHAPTER III

CATARACT

I. Definition(4), (5)

Cataract are changes in clarity of the natural lens inside the eye that gradually

degrade visual quality. The natural lens sits behind the colored part of the eye (iris) in

the area of the pupil. Most cataracts develop slowly and don't disturb the eyesight

early on. But as the clouding progresses, the cataract eventually interferes with the

vision. (4)

Cataract are very common in older people as the process of normal aging.

Many people are in fact unaware that they have cataracts because the changes in their

vision have been so gradual. Cataracts commonly affect both eyes, but it is not

uncommon for cataracts in one eye to advance more rapidly. Cataracts are very

common, affecting roughly 60% of people over the age of 60. But, sometimes it can

be happened because of other diseases, for example diabetes mellitus. (5)

II. Etiology (4)

All cataracts are fundamentally a change in the clarity of the overall lens

structure; however, cataracts may result either early in life or as a result of aging, and

different portions of the lens may be more affected than others. Cataracts that occur at

birth or present very early in life (during the first year of life) are termed congenital or

infantile cataracts. These cataracts require prompt surgical correction or they may

prevent the vision in the affected eye from developing normally. When the central

portion of the lens is most affected, which is the most common situation, these are

termed nuclear cataracts. The outside of the lens is called the lens cortex, and when

opacities are most visible in this region, the cataracts are called cortical cataracts.

There is an even more specific change that occasionally happens, when the opacity

develops immediately next to the lens capsule, either by the anterior, or more

commonly the posterior, portion of the capsule; these are called subcapsular cataracts.

Unlike most cataracts, posterior subcapsular cataracts can develop rather quickly and

affect vision more suddenly than either nuclear or cortical cataracts. (4)

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III. Risk Factors (6)

Everyone is at risk of developing cataracts simply because age is the greatest

risk factor. By age 65, persons have developed some degree of lens clouding,

although it may not impair vision. After age 75, persons have cataracts that are

significant enough to impair their vision. Factors that increase your risk of cataracts

include:

Age

Diabetes

Family history of cataracts

Previous eye injury or inflammation Previous eye surgery

Prolonged use of corticosteroids

Excessive exposure to sunlight

Exposure to ionizing radiation

Smoking

IV. Types of Cataract (6), (7)

Cataracts has three type, they are:

Nuclear.A nuclear cataract is the most cooomonly seen as it forms. It occursin the center of the lens. In its early stages, as the lens changes the way it

focuses light, you may become more nearsighted or even experience a

temporary improvement in your reading vision. Some people actually stop

needing their glasses. Unfortunately, this so-called second sight disappears as

the lens gradually turns more densely yellow and further clouds your vision.

As the cataract progresses, the lens may even turn brown. Seeing in dim light

and driving at night may be especially troublesome. Advanced discoloration

can lead to difficulty distinguishing between shades of blue and purple.

Cortical. A cortical cataract begins as whitish, wedge-shaped opacities or

streaks on the outer edge of the lens cortex. As it slowly progresses, the

streaks extend to the center and interfere with light passing through the center

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of the lens. Problems with glare are common for people with this type of

cataract.

Subcapsular. A subcapsular cataract starts as a small, opaque area just under

the capsule of the lens. It usually forms near the back of the lens, right in the

path of light on its way to the retina. A subcapsular cataract often interferes

with your reading vision, reduces your vision in bright light and causes glare

or halos around lights at night.

Scientists don't know exactly why a lens changes with age. One possibility is

damage caused by unstable molecules known as free radicals. Smoking and exposure

to ultraviolet (UV) light are two sources of free radicals. General wear and tear on the

lens over the years also may cause the changes in protein fibers.

V. Signs and Symptoms (6), (8), (9)

A cataract usually develops slowly and causes no pain. At first, the cloudiness

may affect only a small part of the lens (a clear, elliptical structure near the front of

each eye) and the person may be unaware of any vision loss. Over time, however, as

the cataract grows larger, it clouds more of your lens and distorts the light passing

through the lens. Eventually, this impairs your vision because of overall blur or image

distortion. Signs and symptoms of cataracts include:

Clouded, blurred or dim vision

Increasing difficulty with vision at night

Sensitivity to light and glare

Halos around lights

The need for brighter light for reading and other activities Frequent changes in eyeglass or contact lens prescription

Fading or yellowing of colors

Double vision in a single eye

If a person have cataract, light from the sun, lamps or oncoming headlights

may seem too bright. Glare and halos around lights can make driving uncomfortable

and dangerous. The person may experience eyestrain or find yourself blinking more

often to clear your vision.

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A cataract isn't dangerous to the physical health of the eye unless the cataract

becomes completely white, a condition known as an overripe (hypermature) cataract.

This can cause inflammation, pain and headache. A hypermature cataract requires

removal if it's associated with inflammation or pain.

VI. The Exams and Tests (4),

To detect a cataract, the eye-care provider examines the lens. A

comprehensive eye examination usually includes the following:

Visual acuity test: An eye chart test is used to measure the reading and

distance vision.

Refraction: the eye doctor should determine if glasses would improve the

vision.

Glare testing: Vision may be significantly altered in certain lighting conditions

and normal in others; in these circumstances, the doctor may check the glare

symptoms with a variety of different potential lighting sources.

Potential acuity testing: This helps the ophthalmologist get an idea of what the

vision would be like after removal of the cataract. Think of this as the eye's

vision potential if the cataract was not present.

Contrast sensitivity testing: This checks for the ability to differentiate different

shades of gray, which is often this limited by cataracts.

Tonometry: a standard test to measure fluid pressure inside the eye (Increased

pressure may be a sign ofglaucoma.)

Pupil dilation: The pupil is enlarged with eye drops so that the

ophthalmologist can further examine the lens and retina. This is important to

determine if there are other conditions which may ultimately limit your vision

besides cataracts.

VII. Preventions and Treatments (4), (6), (7), (8)

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Regular eye exams remain the key to early detection. If the over age 65,

schedule eye exams at least every other year. Although most cataracts occur with age

and can't be avoided altogether. In early stages of a cataract when symptoms are mild,

the person can take steps to help slow or possibly prevent the development of

cataracts:

Don't smoke. Smoking produces free radicals, increasing your risk of

cataracts.

Eat a balanced diet. Include plenty of fruits and vegetables in your diet. Eating

lots of fruits and vegetables may have a modest effect in preventing cataract

development, though this hasn't been definitively proved.

Protect yourself from the sun. Ultraviolet light may contribute to the

development of cataracts. Whenever possible, wear sunglasses that block

ultraviolet B (UVB) rays when you're outdoors.

Take care of other health problems. Follow your treatment plan if you have

diabetes or other medical conditions. If you have a chronic illness, it's

especially important that you take other preventive steps, such as wearing

UVB-blocking sunglasses when outdoors and not smoking.

Wearing sunglasses outside during the day might reduce your chances of

developing cataracts or having problems with the retina. Some sunglasses can

filter out UV light, reducing exposure to harmful UV radiation and might slow

the progression of cataracts.

A healthy lifestyle might help, just as a healthy lifestyle helps prevent other

diseases in the body. Eat a proper diet, get regular exercise and rest, and do not

smoke.

Tight blood-sugar control can delay the otherwise accelerated development of

cataracts for the person with diabetes mellitus.

Cataracts can't be cured with medications, dietary supplements, exercise or

optical devices The only effective treatment for cataracts is surgery. It can remove the

clouded lens, which usually includes replacing the lens with a clear lens implant.

Sometimes cataracts are removed without reinserting implant lenses. In such cases,

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vision can be corrected with eyeglasses or contact lenses. Cataract surgery is

successful in about 95 percent of all cases. (6), (8)

Surgery is done on only one eye at a time. It's generally done on an outpatient

basis, usually with local anesthesia. Recovery is fast. The patient can often resume the

normal daily activities beginning the night of surgery and may be able to start driving

again the day after surgery, after the postoperative checkup. There are three basic

techniques for cataract surgery:

Phacoemulsification: This is the most common form of cataract removal as

explained above. In this most modern method, cataract surgery can usually be

performed in less than 30 minutes and usually requires only minimal sedationand numbing drops, no stitches to close the wound, and no eye patch after

surgery.

Extracapsular cataract surgery: This procedure is used mainly for very

advanced cataracts where the lens is too dense to dissolve into fragments

(phacoemulsify) or in facilities that do not have phacoemulsification

technology. This technique requires a larger incision so that the cataract can be

removed in one piece without being fragmented inside the eye. An artificial

lens is placed in the same capsular bag as with the phacoemulsification

technique. This surgical technique requires a various number of sutures to

close the larger wound, and visual recovery is often slower. Extracapsular

cataract extraction usually requires an injection of numbing medication around

the eye and an eye patch after surgery.

Intracapsular cataract surgery: This surgical technique requires an even

larger wound than extracapsular surgery, and the surgeon removes the entire

lens and the surrounding capsule together. This technique requires the

intraocular lens to be placed in a different location, in front of the iris. This

method is rarely used today but can be still be useful in cases of significant

trauma.(4), (7)

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CHAPTER IV

THE CORRELATION BETWEEN DIABETES MELLITUS AND CATARACT

Diabete mellitus is a group of metabolic diseases characterized by high blood

sugar (glucose) levels. Diabetes mellitus is one of the leading causes of irreversible

blindness worldwide, and in the United States, it is the most common cause of

blindness in people younger than 65 years of age.

In addition to being a leading cause of blindness, diabetic eye disease

encompasses a wide range of problems that can affect the eyes. Diabetes mellitus may

cause a reversible, temporary blurring of the vision, or it can cause a severe,

permanent loss of vision. Diabetes mellitus increases the risk of developing cataracts

and glaucoma.

Some people may not even realize they have had diabetes mellitus for several

years until they begin to experience problems with their eyes or vision. Severe

diabetic eye disease most commonly develops in people who have had diabetes

mellitus for many years and who have had little or poor control of theirblood sugars

over that period of time.

Over many years, high blood sugar and other abnormalities in metabolism

found in people with diabetes mellitus may damage the blood vessels in the body.

This damage to the blood vessels leads to poor circulation of the blood to various

parts of the body. Since the function of the blood is to carry oxygen and other

nutrients, this poor circulation causes decreased oxygen delivery to tissues in different

parts of the body and subsequent damage to those tissues.

Some of the most sensitive tissues to decreased blood flow and oxygen delivery

include thebrain, heart, kidneys, and the eyes. Lack of adequate oxygen delivery to

these areas causes strokes, heart attacks, kidney failure, and vision loss.This blurring

is because the sugar in the blood can diffuse into the lens of the eye and cause it to

swell, thus changing the focal point of the eye and resulting in blurring of the vision.

Over time, this repeated swelling of this type is thought to damage the lens and cause

it to become cloudy, resulting in a cataract.

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CHAPTER V

CONCLUSION

Diabetes mellitus as a metabolic disorder that characterize with high blood

glocose levels. It can influence the small and large blood vessels and damaging other

organ in the body, such as kidneys, heart, nerves system, eyes, etc.

In many people, they may not realize about their abnormal level of blood

glucose. So, many people realize they have daibetes mellitus after they feel the

complication of this disease.

One of the common complication is cataract, this diabetes attack the lens of the

eyes that makes the blurry vision on this person. This blurring is because the sugar in

the blood can diffuse into the lens of the eye and cause it to swell, thus changing the

focal point of the eye and resulting in blurring of the vision. Over time, this repeated

swelling of this type is thought to damage the lens and cause it to become cloudy,

resulting in a cataract.

From that mechanisme of diabetes mellitus, this disease can increase the risk of

developing eye diseases, especially cataract.

To treat and prevent this diseases, the person must do some treatment and surgary

to fix the lens and manage the blood glucose levels. And of course, must change the

life-style.

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REFERENCES

1. http://www.emedicinehealth.com/diabetes/article_em.htm. Accesed on July

17th 2011 (internet)

2. http://www.medicinenet.com/diabetes_mellitus/htm#tocn. Accesed on July

17th 2011 (internet)

3. http://jcem.endojournals.org/cgi/reprint/84/4/1165. Accesed on July 17th

2011 (internet)

4. http://www.emedicinehealth.com/cataracts/article_em.htm. Accesed on July 17th

2011 (internet)

5. http://www.cataract.com/. Accesed on July 17th 2011 (internet)

6. http://www.mayoclinic.com/health/cataracts/DS00050/DSECTION=treatment

s-and-drugs. Accesed on July 17th 2011 (internet)

7. http://www.allaboutvision.com/conditions/cataracts.htm.Accesed on July 17th

2011 (internet)

8. http://www.nlm.nih.gov/medlineplus/cataract.html. Accesed on July 17th

2011 (internet)

9. http://adln.lib.unair.ac.id/files/disk1/35/gdlhub-gdl-s1-2006-fauzimasci-1745-

fkm.32-. Accesed on July 17th 2011 (internet)
http://www.emedicinehealth.com/diabetes/article_em.htmhttp://www.emedicinehealth.com/diabetes/article_em.htmhttp://www.medicinenet.com/diabetes_mellitus/htm#tocnhttp://jcem.endojournals.org/cgi/reprint/84/4/1165http://www.emedicinehealth.com/cataracts/article_em.htmhttp://www.cataract.com/http://www.mayoclinic.com/health/cataracts/DS00050/DSECTION=treatments-and-drugshttp://www.mayoclinic.com/health/cataracts/DS00050/DSECTION=treatments-and-drugshttp://www.allaboutvision.com/conditions/cataracts.htmhttp://www.allaboutvision.com/conditions/cataracts.htmhttp://www.nlm.nih.gov/medlineplus/cataract.htmlhttp://www.nlm.nih.gov/medlineplus/cataract.htmlhttp://adln.lib.unair.ac.id/files/disk1/35/gdlhub-gdl-s1-2006-fauzimasci-1745-fkm.32-http://adln.lib.unair.ac.id/files/disk1/35/gdlhub-gdl-s1-2006-fauzimasci-1745-fkm.32-http://www.emedicinehealth.com/diabetes/article_em.htmhttp://www.medicinenet.com/diabetes_mellitus/htm#tocnhttp://jcem.endojournals.org/cgi/reprint/84/4/1165http://www.emedicinehealth.com/cataracts/article_em.htmhttp://www.cataract.com/http://www.mayoclinic.com/health/cataracts/DS00050/DSECTION=treatments-and-drugshttp://www.mayoclinic.com/health/cataracts/DS00050/DSECTION=treatments-and-drugshttp://www.allaboutvision.com/conditions/cataracts.htmhttp://www.nlm.nih.gov/medlineplus/cataract.htmlhttp://adln.lib.unair.ac.id/files/disk1/35/gdlhub-gdl-s1-2006-fauzimasci-1745-fkm.32-http://adln.lib.unair.ac.id/files/disk1/35/gdlhub-gdl-s1-2006-fauzimasci-1745-fkm.32-

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