Week 1 - Crystalline Lens

Question 1

Answer 1

Nuclear sclerosis

Question 2

Answer 2

Nuclear sclerosis
- haze in nucleus
- colour change ( white -yellow -brown)
- Glare and light loss
- Myopic shift

Question 3

Answer 3

Cortical cataract

Question 4

Answer 4

Cortical cataract
- wedges / Spokes in cortex
- starts peripherally with minor effect on VA
- glare
Can expand and coalescing of spokes

Question 5

Answer 5

Posterior sub capsular ( PSC) cataract

Question 6

Answer 6

Posterior sub capsular (PSC) cataract
- symptomatic with glare and reduced VA ( at near vision )
- progress very quickly
- difficult fundus examination

Question 7

Answer 7

Christmas tree cataract
- not common
- polychromatic deposits in Cortex and nucleus

Question 8

Answer 8

Mature cataract
- whole lens opaque
- surgery becomes difficult

Question 9

Answer 9

Mature cataract - hypermature
- morgagnian cataract
- cortex becomes liquid
- nuclear sinks inferiorly

Question 10

Answer 10

Congenital Cataract
- sight threatening / deprivation amblyopia
- babies have red reflex before discharge
- idiopathic
-hereditary
- maternal infection , drug use , malnutrition, metabolic errors , chromosomal abnormalities, prematurity

Question 11

Answer 11

Axial or suture cataract
- chalky white cluster on or near the sutures
- doesn’t reduce vision

Question 12

Answer 12

Blue dot cataract
- small blue dots in outer nucleus / cortex
- doesn’t impact vision as much

Question 13

Answer 13

Secondary cataract ^ glaukomflecken
- result of another ocular disease ( anterior uveitis) ( primary angle closure glaucoma = glaukomflecken)

Question 14

Answer 14

Secondary cataract - anterior uveitis

Question 15

Toxic / induced cataract

Answer 15

Cataractogenic - induce cataract development
E.g - corticosteroid - PSC
- Antipsychotics - Chlorpromazine

Question 16

Answer 16

Traumatic cataracts
- penetrating / blunt injury
- radiation cataract - ionising radiation used for tumour
- complicated surgery
- zonular dialysis - damage to zonular so less stable

Question 17

Answer 17

Pseudo- exfoliation ( not a type of cataract )
- deposits of protein based material at pupil margin and anterior lens capsule
- important cause of secondary glaucoma ( pseudoexfoliative )
- increase risk of intra operative complication in cataract surgery

Question 18

Answer 18

Epicapsular stars
- Iris pigment on the anterior lens capsule

Question 19

Answer 19

Mittendorf dot

• Hyaloid remnant
  •Mittendorf dot on posterior lens capsule

Question 20

Answer 20

Iris Coloboma
- Congenital

•Caused by incomplete closure of the embryonic fissure

•Always inferior (nasal)

•Can be associated with choroid, retinal & optic nerve which may lead to reduced vision

Question 21

Answer 21

Chorio-retinal coloboma

Question 22

Answer 22

Disorder of lens shape and position

Lenticonus
•Anterior or posterior coning of lens surface
•Irregular lenticular astigmatism
•Can cause reduced vision

Question 23

Answer 23

Ectopia lentis
•Subluxation or dislocation of the lens due to zonular rupture
•Can cause glaucoma & uveitis

•Causes of a dislocated lens
•Secondary to other pathology (e.g., Marfan’s, homocystinuria, familial, trauma, anterior uveal tumours, etc.)

Question 24

Answer 24

Lens induced disorders

Glaucoma
•Phakomorphic (caused by lens shape/size)
•Phakolytic (capsular leakage)
•Lens displacement

•Uveitis
•Phakoanaphylactic (Auto Immune sensitivity to lens protein)
•Phakotoxic (toxic reaction to lens protein)