Encyclopedia of Health and Medicine

cicatricial pemphigoid 79
mend wearing dark glasses in bright light to help
protect the eye from light sensitivity. Swelling and
irritation of the tissues around the operated eye is
normal in the first few weeks following surgery.
Clear vision may take four to six weeks, though
many people experience dramatic improvement
immediately. Though the short-term risks of
cataract extraction and lens replacement are
minor, RETINAL DETACHMENT can occur months to
years following surgery.
Cataract extraction is a permanent solution for
cataracts. Once removed, cataracts cannot grow
back. Some people do develop a complication
called posterior capsule opacity, in which the
membrane behind the IOL becomes cloudy
(opaque). This is a complication that results when
residual cells that remain after removal of the lens
begin to grow across the membrane, causing the
membrane to thicken. A follow-up procedure,
either yttrium-aluminum-garnet (YAG) laser capsulotomy
or conventional surgery, is necessary to
remove the membrane.
Outlook and Lifestyle Modifications
About 90 percent of people experience vastly
improved vision after cataract extraction. However,
other eye problems or underlying conditions
(such as RETINOPATHY of diabetes) can affect the
quality of vision. Many people do need eyeglasses
after cataract extraction, as the IOL does not
adjust for focus as does a natural lens. It is important
to see the ophthalmologist for follow-up and
routine eye care as recommended.
See also AGE-RELATED MACULAR DEGENERATION
(ARMD); BULLOUS KERATOPATHY; HYPEROPIA; MYOPIA;
PRESBYOPIA; SMOKING AND HEALTH; SURGERY BENEFIT
AND RISK ASSESSMENT.
chalazion A painless, hard nodule that arises
from a gland (meibomian or sebaceous) along the
edge of the eyelid, the result of glandular secretions
that granulate. A chalazion may extend deep
into the structure of the eyelid. A chalazion sometimes
forms at the site of a recurrent HORDEOLUM
(an infected eyelid SEBACEOUS GLAND, also called a
stye). Often a small chalazion will go away on its
own, without treatment. Moist heat applied to the
eyelid helps dissolve the granulated material and
draw it from the gland. Because of the risk of scarring
and pain, the ophthalmologist may recommend
excising (surgically removing) a chalazion
that does not go away or that recurs. The procedure,
with local anesthetic to numb the eyelid,
takes only a few minutes in the doctor’s office.
The wound typically heals within two weeks and
leaves no scarring. Inflammatory skin conditions
such as DERMATITIS or ROSACEA can block the eyelid’s
glands, causing a chalazion to develop. Careful
eyelid hygiene helps keep secretions from
accumulating.
See also BLEPHARITIS; CONJUNCTIVITIS; OPERATION.
cicatricial pemphigoid An autoimmune disorder
in which painful blisters form on the inner
surfaces of the eyelids (and may form on other
mucus membranes, such as in the MOUTH and
NOSE). SCAR tissue that forms after the blisters heal
continues to irritate the inner eyelids as well as
the outer surface of the EYE (sclera and CORNEA).
The blisters commonly involve the lacrimal (tear)
glands and ducts, reducing tear production and
causing DRY EYE SYNDROME. Cicatricial pemphigoid
occurs when the body’s IMMUNE SYSTEM produces
antibodies that attack the cells that form the
mucus membranes. Trauma appears to activate
the eruptions of blisters and may be as inconsequential
as rubbing the eye or the irritation such
as occurs with exposure to environmental particulates
such as pollen and dust. Some people first
experience outbreaks of cicatricial pemphigoid following
eye operations such as CATARACT EXTRACTION
AND LENS REPLACEMENT or BLEPHAROPLASTY.
The diagnostic path includes laboratory tests to
assess the levels of antibodies in the blood, particularly
IMMUNOGLOBULIN G (IGG) and IMMUNOGLOBIN A
(IGA), the antibodies most closely associated with
cicatricial pemphigoid. Treatment focuses on
reducing BLISTER formation and minimizing scarring,
typically by taking oral CORTICOSTEROID MED-
ICATIONS or IMMUNOSUPPRESSIVE MEDICATIONS. As with
other AUTOIMMUNE DISORDERS, cicatricial pemphigoid
tends to be chronic and recurrent. The
persistent irritation can result in damage to the
cornea that causes VISUAL IMPAIRMENT and, when
severe, results in blindness.
See also ANTIBODY; CONJUNCTIVITIS; CORNEAL
TRANSPLANTATION; ECTROPION; HUMAN LEUKOCYTE ANTI-
GEN (HLA).