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Senile Cataract (Stages of Maturation (Hyper mature (Morgagnian form…
Senile Cataract
Stages of Maturation
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Immature senile cataract
Diffuse & irregular Opacification
Greyish white Lens
Visible iris shadow
Sometimes Lens become swollen due to continued hydration & leads to shallow anterior chamber ➡️ This condition is called “Intumescent Cataract “
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Hyper mature
Morgagnian form
Liquification of Whole cortex
Lens is converted into bag of Milky fluid
Small brownish nucleus settles at the bottom
Sclerotic form
Disintegration of Cortex
lens becomes shrunken
Wrinkled & Thickened anterior capsule due to proliferation of anterior cells
leads to Dense white capsular cataract
deep anterior chamber
Iridodonesis( tremulous iris )
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Complications
Phacoanaphylactic Uveitis
due to leakage of Lens proteins in anterior chamber
Acts as Antigen➡️Anaphylaxis
Lens induced Glaucoma
Phacolytic (2 Angle closure Glaucoma )due to intumescent lens
Phacomorphic ( 2 open angle Glaucoma) in morgagnian catract due to blockade of trabecular meshwork by Macrophages engulfed with Lens proteins
Phacotopic Glaucoma in hyper mature catract due to blockade of pupil
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Risk factors
50 years
Both sex
Heredity
UV irradiation ➡️Early onset & Maturation
Dietary deficiency of amino acids , Vitamins E& C , riboflavin,
Prior episode of Dehydration crisis (Diarrhoea & Cholera )
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Pre senile Catract
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Causes
Heredity
DM ( Nuclear cataract -More common )
Myotonic Dystrophy ➡️Christmas tree Catract ( Posterior subcapsular Catract )
Atopic dermatitis
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Clinical Features
Glare / Dazzle / Intolerance to bright light
Uniocular polyopia due to irregular refraction
Coloured halos ➡️Breaking of white light into coloured spectrum due to presence of water droplets in Lens
Black spots in front of eye
Blur & Misty Vision
Painless & progressive loss of Vision
In Cupuliform Catract : Early loss of vision & improved vision in dilated pupil ( Dim light )
In Cuneiform catract : Late loss of vision & improved vision in contracted pupil (Presence of Bright light )
In nuclear sclerosis : Deterioration of Distant vision due to progressive index myopia & improvement in near vision ( Patient may be able to read without presbyopic glasses ➡️ Referred as “Second Sight” )
Morphological type
Cortical - Soft ➡️ Cuneiform (more common )/ Cupuliform (Posterior subcapsular cataract )
Nuclear - Hard
50 years
1 Eye affected earlier than another