ABIM Exam Disease of the Week Profile: Cataracts

Cataracts - Topic Review for USMLE Step Exam


Remember learning about dogaracts during med school? Neither do I. But let’s take a minute to review cataracts, which are opacities or a clouding of the ocular lens. Worldwide, they represent the leading cause of blindness. In the US, one out of every two octogenarians previously had or currently has a cataract.



As is the cause with many eye conditions, the risk of developing cataracts increases with advanced age. Other risk factors include smoking ultraviolet light exposure (especially UV B), and diabetes. Systemic, topical, or ophthalmic corticosteroid use. Not surprisingly, a positive family history also increases one’s own risk of having cataracts.



• Glare

• Reduced color perception (“faded colors”)

• Diplopia

• Decreased visual acuity, especially at nighttime



Two possible ways of preventing the development of cataracts is quitting smoking and wearing sunglasses that block ultraviolet B rays. Some early reports suggest that the antioxidant N-acetylcarnosine (NAC) is effective as well. These eye drops are available over the counter.



The primary method of treating cataracts is surgical removal of the defective lens and replacement with a new intraocular lens. It is best to promptly treat the cataracts as delaying surgery for longer than 6 months has been linked to an increased incidence of falls and overall worsening quality of life when compared to those who underwent the surgery within 6 weeks. Cataract surgery is one of the safer procedures performed with a complication rate less than 2%. For this reason, despite the paperwork issued by many surgical centers, cataract surgery does not usually even require perioperative medical consultation.



The famous Impressionist painter, Claude Monet is known to have suffered from cataracts. In fact, the disorder is believed to have been at least partially responsible for the blurriness and heavy emphasis on the red color observed in Monet’s paintings of the early 1900s. After he underwent cataract surgery in 1923, his paintings featured an increased amount of light, likely reflecting his own increased perception.


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“The Duplex” comic is created by Glenn McCoy. This particular strip was printed on June 11, 2013

Content adapted from MKSAP edition 15, American College of Physicians, 2010


You can see all the previous ABIM Exam disease of the week blog posts at the Knowmedge Blog. You can find also additional topics and questions directly from the Knowmedge Internal Medicine ABIM Board Exam Review Questions QVault.

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