Crystalline Lens (Age Related Cataracts)

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16 Terms

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Cataracts

Lenticular opacification

Leading cause of preventable blindness

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Cataracts risk factors

  • 50-70s

  • UV light exposure

  • Steroid use (typically oral)

  • Smoking


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When should you refer out for cataract Sx?

  • 20/40 VAs

  • Pt daily life is affected

  • Can’t see retina

Typically refer out 70-80s

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What does vision with cataracts look like?

  • Loss of details

  • Blurry vision

  • Glare/halos


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Nuclear Sclerotic Cataract (NSC)

Yellowing of the lens from urochrome pigment deposition in the nucleus

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NSC clinical findings

  • Myopic shift due to changes in refractive index of lens

  • Becomes more brown with age


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Cortical cataracts

Opacities start in periphery and grow central

Pt experiences glare, decreased vision for dist (driving at night when pupil is dilated) and near (if in visual axis), and decreased contrast sensitivity

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Cortical cataracts clinical findings

  • Clefts: Accumulation of fluid between fibers

  • Wedges/spokes: Clefts that collect cellular debris and become opaque

  • Vacuoles: Fluid filled bubbles within cortex


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Posterior subcapsular cataract (PSC)

Associated with long term oral steroids and diabetes, appears central

Found in younger pts (50-60s)

Pts complain of glare, difficulty seeing in bright light, or reduces near VA

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PSC clinical findings

Granular, vacuolated, or plaque like opacity that is on visual axis

Push through on retro because on posterior capsule

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Hypermature cataract

Age related cataract that kept worsening because it was never removed

Pt will have severe reduction in VA (20/400 or hand motion)

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Hypermature cataracts clinical findings

  • Wrinkling of ant capsule

  • Liquification of cortex

  • Shrinking of nucleus


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Hypermature cataracts complications

Secondary glaucoma

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Morgagnian cataract

Even more advanced hypermature cataract

Pt will have significant reduction in VA

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Morgagnian clinical findings

  • Progressive liquification of the cortex → Milky white

  • Nucleus will become free floating and drop inferior


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Morgagnian complications

Secondary glaucoma