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Cataracts - Coggle Diagram
Cataracts
Congenital Cataract
Features
2/3 bilateral
unilateral sporadic
AD
Clinical types
Capsular cataract
Anterior and Posterior
Polar cataract
Anterior and posterior
Sutural cataract
anterior and posterior Y sutures
Nuclear cataract
Lamellar cataract
most common type
40-50% of total
circular lamella of lens
sharply demarcated opacity
clear lens fibers within and around it
Insults that affect developing lens
Bilateral
AD
May be associated with
Metabolic disorders
Uterine infections
Central oil droplet cataract
Galactosemia
Nuclear and deep cortex
Coronary
Supranuclear
Puberty
Central axis clear
vision unaffected
AD
Punctate
Blue-dot
Multiple small opaque
scattered stationary dots
Vision unaffected
Membranous
thin membranous
Complete
dense white nuclear cataract
Etiology
Maternal causes
Infections
Congenital Rubella
Intrauterine hypoxia
Placental insufficiency
Radiation
Drugs
Corticosteroids
Endocrine disorders
DM
Fetal causes
Hereditary cause
AD
Chromosomal disorders
Downs
Ocular anomalies
Aniridia
Metabolic disorders
Galactosemia
Lowe syndrome
Trauma
Forceps delivery
Unknown cause
30-35%
Clinical features
Symptoms
Decreased vision
Whitish reflex in pupillary area
Abnormal eye movements
Deviation of eye
Signs
Vision reduced
Leukocoria
Squint
convergent
Nystagmus
Slit lamp reveals type
Ocular assessment
Density and morphology noted
Partial cataract
Fundus examination
Retinoscopy
Total cataract
B-scan
A-scan
compare axial length of two eyes
IOP
Lab investigations
Urine analysis
Galactosemia
Lowe's syndrome
Serum biochemistry
Serological test
Treatment
Lens aspiration
GA
Corneo scleral incision
Ant. Capsulectomy
Aspiration and irrigation of soft lens matter
Posterior capsulectomy
limited anterior vitrectomy
1 more item...
Lensectomy
Thru Pars Plana
Removal of entire lens along with ant. vitreous
Vitreous cutter
Infusion and suction device
Special cases of congenital cataract
chronic ant. uveitis
Ectopia Lentis
Subluxated lens
Post-Op complications
Post. capsule opacification
Sec. membrane formation
Secondary glaucoma
Visual rehabilitation
Spectacles
bilateral
Contact lenses
unilateral
IOL
Acquired cataract
Types
Capsular
Subcapsular
Cortical
Nuclear
Total
Etiology
Age
Trauma
stellate or rosette shaped
Radiation
Metabolic disorders
Ocular disorder
Ant segment diseases
Corneal Ulcer
Acute congestive glaucoma
Ant. uveitis
Post. segment diseases
Retinitis Pigmentosa
Degenerative myopia
Drugs
Corticosteroids
Chlorpromazine
Skin
Atopic dermatitis
Muscular
Myotonic dystrophy
Neurologic
Wilsons
sunflower appearance
Osseous
OI
Syndromes
Down
Lowe's
Werner
Rothman
Senile cataract
Types
Subcapsular
Young patients
Saucer shaped opacity
central part of post. cortex
nodal point
Worse vision at daytime
Cortical
Hydration of lens due to changes in permeability
Stages
Lamellar separation
Demarcation of cortical fibres
Inc. reflection and scattering of light
glare
Grayness of lens but no opacity
Incipient Cataract
wedge shaped opacity
cortical spokes
dec. vision
halos diplopia polyopia
Intumescent
swelling of lens
shallowing of ant. chamber
Closed angle glaucoma
Mature
entire cortex from capsule to nucleus opacified
Immature
Enlarge wedge
coalesce forming diffuse large opacities
RI cortex= nucleus
Hypermetropia shift
Nuclear
Inelastic hard lens
Myopic shift
Nuclear fibres dehydration
compaction
sclerosis
Fate of mature cataract
Hypermature cataract
disintegration
pultaceous mass
denatured proteins leak from lens capsule
phacolytic glacuoma
leakage of proteins
capsule wrinkled and shrunk
Morgagnian cataract
Pulcateous mass
liquefaction
Nucleus sinks to bottom
Milky cortex
Subluxation
suspensory ligaments degenerate
dislocation
Clinical features
Symptoms
Painless gradual vision deterioration
Glare
Monocular diplopia
Colored halos
Change in refractive power
Worsening of vision during daytime
Glaucoma
Signs
Dec. visual acuity
Opacification of lens
Diagnosis
Simple torch
Distant direct ophthalmoscope
Slit lamp exam
Complications of cataract
Phacomorphic glaucoma
swollen lens pushes against iris
Relative pupillary block
Phacolytic
Phacoantigenic uveitis
trauma causes tears
cataract formation
Lens protein release
antigen antibody reaction
Uveitis may lead to inflammatory glacuoma
Dislocation
Vitreous
okay if intact
Vitritis if leaky
Ant. chamber
hypermature
shrinkage
Pupillary block glaucoma
incarcerated in pupil
Management
no medical treatment
Spectacles
Dark glasses
Pupillary dilatation with mydriatics
Surgical
extraction
Indications
Visual improvement
Medical indications
complications present
Cosmetic indications
Classification
Age
Congenital Cataract
Juvenile Cataract
Presenile Cataract
Adult cataract
Infantile Cataract
Senile Cataract
Location of Opacity
Capsular
Subcapsular
Cortical
Supranuclear
Nuclear
Total
Degree of opacity
Incipient Cataract
Immature Cataract
Intumescent cataract
Mature cataract
Hypermature Cataract
Mogagnian
Calcified
Etiology
Congenital
Acquired