Cataracts

Author: Hamza Shah, OD, MS

Image obtained from: Yanof Ophthalmology. LENS

Image obtained from: DOI: 10.1167/tvst.6.6.2

Image obtained from: DOI: 10.3390/jimaging8020041

  • Congenital Cataract

  • Nuclear Sclerosis
    • Notice distance issues more than near
    • May notice a myopic shift, especially if cloudy center

  • Cortical Cataract
    • Glare is the common symptom with this cataract

  • Posterior Subcapsular Cataract
    • Decreased vision
    • Younger patients
    • High myopes

  • Anterior Subcapsular Cataract

  • Christmas Tree Cataract
    • Myotonic dystrophy (muscular dystrophy also affects other systems i.e., CNS)

  • Traumatic Cataract
    • Blunt, electric, UV, radiation, chemical

  • Systemic Disease
    • Myotonic dystrophy, atopic dermatitis, T2DM, and neurofibromatosis type 2
    • Diabetic snowflake (younger age): happens due to osmotic stress from the increase in intralenticular sorbitol due to increased glucose

  • Secondary Cataract
    • Uveitis, angle closure, myopia, medications, alcohol

38 year old male presented with constant blurry vision in the right eye with a history of trauma in the right eye couple months prior. Complained blurry vision seems to be consistence since the trauma.  

Traumatic Cataract Formation

Disruption of the lens fibers after trauma leads to cataract formation.

Incidence and Impact:

  • Approximately 65% of eye traumas result in cataract formation, affecting around 1.6 million people annually worldwide.
  • This condition is more common in males than females.
  • Cataracts can develop immediately after trauma or may take time to become apparent.

Associated Ocular Damage:

  • Damage to the lens capsule and zonules.
  • Formation of synechiae (adhesion of the iris to the lens or cornea).
  • Reduced media clarity, which can impair vision.
  • Potential involvement of other ocular structures, leading to further complications.

Upon gonioscopy, a widened ciliary body band was observed, leading to the diagnosis of angle recession. This underscores the importance of performing gonioscopy in patients with a history of ocular trauma.

More on angle recession will be discussed in a later case.

 

References:

Okoye GS, Gurnani B. Traumatic Cataract. [Updated 2023 Aug 27]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK594251/

EyeWiki. (n.d.). Cataract. EyeWiki. Retrieved August 29, 2024, from https://eyewiki.org/Cataract