Cataracts Flashcards
1
Q
Nuclear Sclerosis
- Etiology
- Signs?
- Refractive shift
- Speed of progression?
A
Hardening and yellowing of the lens nucleus
- Etiology: Age
- Signs?: Yellow lens nucleus, may progress to brown.
- Refractive shift: Myopic refractive shift
- Speed of progression?: Slow.
2
Q
Cortical cataract
- Etiology
- Early sign
- Late signs
- Refractive shift
- Speed of progression?
A
Opacification of the lens cortex
- Etiology: Age related
- Early signs: Cortical water clefts and vacuoles
- Late signs: Spoke or wedge like opacities in the cortex. Begins in the periphery then approach visual axis.
- Refractive shift: typically a hyperopic shift and lenticular cyl.
- Speed of progression?: Very slow.
3
Q
Mature cataract
- Etiology
- Symptoms
- Signs?
- Complications
- How to evaluate posterior segment pathology
A
Complete opacification of the entire lens
- Etiology: Progression of cortical or nuclear cataract
- Symptoms: Significantly blurred vision.
- Signs? Opacification of entire lens. Leukocoria. Shallow anterior chamber.
- Complications- phacomorphic glaucoma. Lens changes shape and causes glaucoma.
- Order B scan.
4
Q
Hypermature cataract. (morgagnian cataract)
- What is it?
- Etiology
- Symptoms
- Signs
- Complications
A
- What is it? Mature cataract with liquefaction of the cortex and sinking of the nucleus to the bottom of the lens capsule.
- Etiology: Progression of a mature cataract
- Symptoms: Significantly blurred vision
- Signs: Complete opacification of the entire lens with the nucleus floating freely in the liquefied cortex. Leukocoria. Shallow anterior chamber.
- Complications: lens capsule rupture can cause uveitis or glaucoma.
5
Q
Posterior sub capsular cataract
- What is it?
- Etiology
- Symptoms
- Signs
- Progression
A
- What is it?: Opacification between the posterior cortex and capsule.
- Etiology: age related. Also associated with uveitis, prolonged steroid use, systemic disease, radiation.
- Symptoms: Blurred vision at near
- Signs: Granular or plaque like opacification anterior to the posterior capsule. commonly begins as a round opacity in the visual axis.
- Progresses more rapidly than other cataracts.
6
Q
Anterior sub capsular cataract
- What is it?
- Etiology
- Signs
A
- What is it? opacification between the anterior capsule and cortex.
- Etiology: Associated with angle closure. Cataract is called glakomflecken. Meds, radiation.
- Signs: Granular or plaque like opacification posterior to the anterior capsule.
7
Q
Sunflower cataract (Chalcosis lentos)
Opacification
Etiology
Signs
Management
A
Opacification in a sunflower pattern between the anterior capsule and cortex.
Etiology: Coper deposition. Wilson disease.
Signs: Yellow, green, or red sunflower like opacification beneath the anterior capsule.
Management: refer to PCP for eval of wilson’s disease. May resolve if improvement in copper levels.
8
Q
Snowflake cataract
- What is it?
- Etiology
- Signs
- Management
- Progression
A
- What is it: White opacities in the cortex.
- Etiology: DM
- Signs: White, snowflake like opacities in the cortex
- Management: Refer to PCP for DM eval. May resolve.
- Progression: Progresses rapidly
9
Q
Christmas Tree cataract (polychromatic cataract)
- What is it?
- etiology
- May evolve into
- Management
A
- What is it: Glittering, multi colored opacity in the cortex.
- etiology: Myotonic dystrophy, rarely. Age related.
- May evolve into typical cortical or sub capsular opacities like in a star conformation.
- Management: refer to PCP for myotonic dystrophy eval.
10
Q
After cataract (posterior capsular opacification- PCO)
- What is it?
- Etiology
- Signs
- Management
- Up to ___% of patients develop PCO after surgery
A
- What is it: Opacification between a PCIOL and posterior capsule.
- Etiology: proliferation of lens epithelial cells onto the posterior capsule.
- Signs: Granular or plaque like opacification of the posterior capsule. Elschnig’s pearls, wrinkling of the posterior capsule.
- Management: YAG
- Up to 50% of patients develop PCO after surgery
