Cataract | Notion

Classification

Type	Etiology	Morphology	Age of Onset
Congenital	Genetic factors, Maternal infections	Nuclear, Total	Birth or early childhood
Age-related (Senile)	Aging process, Oxidative stress	Nuclear, Cortical, Subcapsular	Usually >60 years
Traumatic	Physical injury, Chemical exposure	Varies based on trauma	Any age
Metabolic	Diabetes, Galactosemia	Snowflake, Cortical	Variable
Drug-induced	Steroids, Anti-psychotics	Posterior subcapsular	Variable

1.ACQUIRED CATARACT

Age-related (Senile) Cataract
- Most common type
- Bilateral but often asymmetric
- Progressive clouding of lens
Traumatic Cataract
- Due to blunt/penetrating trauma
- Usually unilateral
Drug-induced Cataract
- Corticosteroids most common cause
- Usually bilateral

*Age related/ Senile Cataract

Nuclear Cataract
- Affects central portion of lens
- Causes gradual yellowing or browning
- May temporarily improve near vision ("second sight")
Cortical Cataract
- Begins in lens periphery
- Appears as wedge-shaped opacities
- Affects distance vision more than near vision
Posterior Subcapsular Cataract
- Forms at back of lens
- Affects near vision more than distance
- Progress more rapidly than other types

Stages of maturation in senile cataract:

A. Maturation of cortical type of senile cataract:

Incipient stage
- Early stage with cuneiform/wedge-shaped opacities in periphery
- Radial spoke-like opacities visible on dilated examination
Progressive stage
- Opacities increase in size and number
- Multiple sectors of lens cortex become involved
- Vision gradually deteriorates
Complete stage
- Entire cortex becomes opaque
- Marked visual impairment
- May progress to mature cataract stage
Immature Cataract
- Partial lens opacity
- Some clear zones remain
- Red reflex present
Mature Cataract
- Complete lens opacity
- No clear zones
- No red reflex
Hypermature Cataract
- Liquefaction of cortical matter
- Lens proteins leak through capsule
- Wrinkled capsule
- Risk of complications increases