Chapter 1 Assessment - Types of Cataracts

Classic Types of Cataract


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Nuclear Cataract

Epidemiology / Risk Factors

• Age
• Riboflavin, vitamin C, vitamin E and carotene may decrease risk of nuclear sclerosis
• Cigarette smoking increase the risk of nuclear sclerosis

Symptoms / History

• Gradual progressive loss of vision
• Second sight -- development of myopia due to increased lenticular refractive index
• Monocular diplopia
• Decreased color discrimination especially blue

Clinical features

• Central yellow to brown discoloration of the lens
• Myopic shift
• Bilateral
• Decreased penetration of cobalt blue slit beam through lens

Posterior Sub-Capsular Plaque (PSCP)

Epidemiology/Risk Factors

• Younger patients than with nuclear or cortical cataracts
• Diabetes mellitus
• Radiation
• Corticosteroids
• Uveitis and retinitis pigmentosa
• Smoking

Symptoms/history

• Progressive loss of vision, sometimes rapid
• Glare, halos
• Monocular diplopia

Clinical features

• Axial opacity of the posterior cortical material that initially has an iridescent sheen and appears in the posterior cortex that is followed by granular and plaque like opacities.
• Can be confused with posterior polar cataract and mittendorf dot
• Can see with direct but best viewed with red reflex through slit lamp

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Cortical Cataract

Epidemiology/Risk Factors

• Younger patients than with nuclear cataracts
• Diabetes mellitus
• Sunlight
• Trauma
• Smoking

Symptoms/history

• Progressive loss of vision, sometimes rapid
• Glare, halos
• Monocular diplopia

Clinical features

• Opacity of the cortical fibers from posterior to central
• Sometimes wedge shaped forming cortical spokes
• Can progress to intumescent or hypermature cataract
• Usually medial and inferior from UV exposure

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