PANCE Blueprint EENT (7%)

Patient presents as → a 78-year-old man who complains of slowly progressive vision loss over the last several years. He describes his vision as if he is looking through "dirty glass" and reports seeing a white halo around lights. On physical exam, there is clouding of the lens and no red reflex.

To watch this and all of Joe Gilboy PA-C's video lessons you must be a member. Members can log in here or join now.

Cataracts are an opacity of the lens that affects the vision and are the leading cause of blindness worldwide

• Risk factors for cataracts include age (usually > 60), smoking, ETOH, sunlight exposure, diabetes, metabolic syndrome, prolonged drug use (esp. glucocorticoids), radiation
• Seen with prolonged systemic or inhaled steroid use and statins

Cataract appears dark against the red reflex on exam

• Slit lamp to magnify, difficult to see the fundus

In the early stages, lifestyle modifications like using glasses, brighter lighting, anti-glare sunglasses, and pupillary dilation (with phenylephrine 2.5% every 4 to 8 hours) can be effective

• Definitive treatment is with cataract removal - Surgery is generally reserved for more severe cases where vision impairment significantly affects daily activities