Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Cataract Surgery


Related Terms

  • Age-related Macular Degeneration (ARMD)

Specialists

  • Ophthalmologist

Comorbid Conditions

Factors Influencing Duration

The method of cataract removal used, any complications, and the individual's response affect length of disability.

Medical Codes

ICD-9-CM:
13.11 - Intracapsular Extraction of Lens by Temporal Inferior Route
13.19 - Other Intracapsular Extraction of Lens; Cataract Extraction NOS; Cryoextraction of Lens; Erysiphake Extraction of Cataract; Extraction of Lens NOS
13.2 - Extracapsular Extraction of Lens by Linear Extraction Technique
13.3 - Extracapsular Extraction of Lens by Simple Aspiration (and Irrigation) Technique; Irrigation of Traumatic Cataract
13.41 - Phacoemulsification and Aspiration of Cataract
13.42 - Mechanical Phacofragmentation and Aspiration of Cataract by Posterior Route
13.43 - Mechanical Phacofragmentation and Other Aspiration of Cataract
13.51 - Extracapsular Other Extracapsular Extraction of Lens by Temporal Inferior Route
13.59 - Extraction of Lens
13.64 - Discission of Secondary Membrane [after Cataract]
13.65 - Excision of Secondary Membrane [after Cataract]; Capsulectomy
13.66 - Mechanical Fragmentation of Secondary Membrane [after Cataract]
13.69 - Cataract Extraction, Other

Overview

Surgery is the only option for correcting advanced cataracts that occur when the natural lens behind the iris or colored portion of the eye becomes cloudy and obstructs vision. In most procedures, the eye's natural lens cortical material is removed and replaced with an artificial intraocular lens (IOL). In rare cases when an artificial lens is not implanted, the individual may need to wear thick glasses or contact lenses (aphakic) to replace natural lens refractive power.

The type of procedure used for cataract removal depends on individual needs, condition of the eye, and type of vision correction planned after removal of the eye's natural lens cortical material (lens fibers). Phacoemulsification is by far the most common procedure. With this method, high-frequency sound waves (ultrasound) are transmitted into the eye through a probe in order to fragment the lens cortical material into pieces for removal. Extracapsular cataract extraction requires larger incisions to allow the surgeon using a microscopic instrument to manually remove the lens materials. In both procedures, the capsule holding the natural lens is left in place. An older and now rarely used procedure called intracapsular extraction involves manual removal of the whole lens and entire capsule. Individuals undergoing this process may have to wear thick glasses or contact lenses (aphakic) to replace vision lost with removal of the natural lens.

New materials and designs in intraocular lenses implanted after cataract surgery have greatly expanded options for vision correction. Some artificial lenses now allow a full range of vision, close up to distance, although some complications such as nighttime glare have been reported. Many individuals who wore spectacles or contact lenses prior to cataract surgery now report much improved unassisted vision following cataract surgery because of artificial lenses. Other lenses contain materials that block ultraviolet sun rays, which potentially can damage the internal lining of the back of the eye (retina). Researchers now are investigating use of a technology called wavefront to measure the way cataracts scatter light rays and hamper vision. This technology might lead to improvements in the way vision and needed corrections are assessed for cataract surgery.

Aging and accompanying biochemical changes in the natural lens are considered the main reason for development of cataracts, although injury or ocular disease may also be contributing factors. Sunlight, nutritional deficiency, heredity, diabetes, and metabolic disorders also may contribute to formation of cataracts. More than half of people aged 65 or older have cataracts (Cataract). Cataract removal is the most common surgery for this age group.

Source: Medical Disability Advisor



Reason for Procedure

Cataracts are removed when they are cloudy enough to interfere with vision during daily activities of life. While mild cataracts may require only glasses or contact lenses for vision correction, surgical removal is needed when the condition becomes so severe that daily activities are hampered.

Source: Medical Disability Advisor



How Procedure is Performed

A physical exam prior to the procedure will ascertain health risks. An ultrasound of the eye determines the type and power of the intraocular lens needed to replace the individual's natural lens where the cataract is located. Surgical procedures are usually performed on an outpatient basis in a clinic or surgical center. A sedative may be administered. Anesthesia is applied topically or injected into the orbit.

In the most common procedure, called phacoemulsification, the surgeon uses an operating microscope and precision instruments to cut a small, usually self-sealing incision into the anterior one-third of the eye (cornea). A probe attached to a phacoemulsification machine is then inserted to administer high-frequency ultrasonic vibrations that will shatter the lens cortical material of the eye. The phaco machine also sends liquid through the probe for suctioning and irrigating to remove fragments and clean the wound. If the surgeon uses the extracapsular cataract extraction technique, the cataract and natural lens will be removed manually in one piece through a larger incision.

An artificial lens then is inserted into the now empty capsular bag (capsule) that once surrounded the lens fibers. No sutures are usually needed to close the wound unless the extracapsular cataract extraction method is used. A shield is taped over the eye for protection. Surgery is performed on only one eye at a time. Eyedrops and over-the-counter pain medication may be prescribed. Most procedures take no longer than 30 minutes depending on the severity of the cataract.

Source: Medical Disability Advisor



Prognosis

Recent refinements in cataract surgical techniques now mean a 98% success rate. Most complications are also successfully treated. In many cases, individuals experience improvement in previous vision because of implantations of newly developed intraocular lenses designed to correct refractive errors. Healing should be complete within several months although glasses may be required to correct residual vision deficiencies such as inadequate near vision caused by aging (presbyopia). Most normal, nonstrenuous activities not associated with keen visual acuity can be resumed within a day or two after surgery.

Source: Medical Disability Advisor



Complications

A common complication of cataract surgery may occur days, months, or years later when the back portion of the lens capsule clouds over (posterior capsular opacification or secondary cataract). The condition is usually easily and painlessly treated with a laser that penetrates the membrane, allowing the cloudiness to clear away (YAG laser capsulotomy). Cataract surgery may cause light sensitivity accompanied by halos or glare. Rare complications include induced astigmatism, infection, corneal swelling or cloudiness, excessive bleeding in the eye, retinal detachment, and glaucoma (high eye pressure which causes optic nerve damage and can result in permanent vision loss). If the implanted artificial lens becomes dislocated, re-treatment may be needed. Extremely rare complications may include blindness or loss of the treated eye.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Depending on the procedure, the individual may need to move cautiously and avoid heavy lifting, bending and straining for 1 month. An eye shield or glasses should be worn to protect the eyes. Eyesight testing may be needed to determine the individual's ability to perform tasks requiring specific visual acuity.

Source: Medical Disability Advisor



References

General

Blecher, Mark H. "What's New in Cataract." Review of Ophthalmology 11 4 (2004): 490-490. Review of Ophthalmology. 19 May 2005 <http://www.revophth.com/index.asp?page=1_489.htm>.

Source: Medical Disability Advisor






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