CLINICAL Presentaton OF CATARACTS-4.pptx

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1. Disorder of lens Md. Asaduzzaman Associate Optometrist

2. Crystalline Lens Structure IIEI&H

3. Anterior lenticonus is a rare condition in which there is a conical or spherical protrusion of the anterior lens surface into the anterior chamber. Disorder of lens shape and position

4. Posterior lenticonus is a rare progressive disease characterized by protrusion of posterior lens capsule along with lens cortex into the vitreous cavity. Posterior lenticonus is more common. Disorder of lens shape and position

5. Posterior Lenticonus

6. Spherophakia is a rare congenital bilateral eye disorder, which presents with weak zonules around a smaller and more spherical crystalline lens with an increased anteroposterior thickness of the lens, and highly myopic eye. Disorder of lens Shape and position

7. Cataract A cataract is a clouding of the lens in the eye which leads to a decrease in vision. Cataracts often develop slowly and can affect one or both eyes. Symptoms may include faded colors, blurry vision, halos around light, trouble with bright lights, and trouble seeing at night. In short any opacity of the lens is called cataract. cataract IIEI&H

8. A . Congenital and developmental cataract B. Acquired cataract:- 1. Senile cataract 2. Traumatic cataract 3. Complicated cataract 4. Metabolic cataract 5. Radiation cataract 6. Toxic cataract e.g. i .Corticosteroid-induced cataract ii. Miotics -induced cataract iii. Copper and iron 7. Cataract associated with skin diseases 8. Cataract associated with osseous diseases. 9.Cataract with common syndromes.e.g i . Dystrophica myotonica ii. Down's syndrome. Etiological Classification of Cataract IIEI&H

9. Congenital Cataract Congenital cataracts refers to a lens opacity present at birth. Its may be  unilateral  or  bilateral . They can be classified by morphology, presumed or defined genetic cause, presence of specific metabolic disorders, or associated ocular anomalies or systemic findings. IIEI&H

10. Common Types of Congenital Cataracts I.Congenital capsular cataracts Anterior capsular cataract 2. Posterior capsular cataract II. Polar cataracts Anterior polar cataract Posterior polar cataract III. Nuclear cataract IV. Lamellar cataract V. Sutural and axial cataracts VI. Generalized cataracts Coronary cataract Blue dot cataract Total congenital cataract Congenital membranous cataract IIEI&H

11. Morphological Classification of Cataract 1. Capsular cataract: It involves the capsule and may be: i . Anterior capsular cataract ii. Posterior capsular cataract 2. Subcapsular cataract: It involves the superficial part of the cortex (just below the capsule) and includes: Anterior subcapsular cataract ii. Posterior subcapsular cataract 3. Cortical cataract: It involves the major part of the cortex. 4. Supranuclear cataract: It involves only the deeper parts of cortex (just outside the nucleus). 5. Nuclear cataract: It involves the nucleus of the crystalline lens. 6. Polar cataract: It involves the capsule and superficial part of the cortex in the polar region only. IIEI&H

12. Nuclear Sclerosis Nuclear sclerosis is the most common type of cataract, and involves the central or 'nuclear' part of the lens. Grade’s standards of nuclear hardness: Ⅰ. Transparent,no nucleus,soft Ⅱ. Yellow-white or yellow,soft Ⅲ. Dark yellow,moderate hard Ⅳ . Brown or amber, hard Ⅴ . Brown or black,extremely hard IIEI&H

13. Cortical Cataracts Cortical cataracts are due to the lens cortex (outer layer) becoming opaque. They occur when changes in the fluid contained in the periphery of the lens causes fissuring. IIEI&H

14. Posterior Subcapsular Cataracts Posterior subcapsular cataracts are cloudy at the back of the lens adjacent to the capsule (or bag) in which the lens sits. IIEI&H

15. Coronary Cataract A cataract believed to be congenital, in which club-shaped opacities develop in the periphery of the cortex near the lens equator. IIEI&H

16. Blue Dot Cataract Blue dot  cataract is a type of hereditary congenital cataract distinguished by bluish and white opacifications in the superficial layers of the fetal lens nucleus and adult lens nucleus. IIEI&H

17. Total Cataract A fully clouded lens, meaning total lental opacity including vision loss. IIEI&H

18. Traumatic Cataract Traumatic cataract is an opacity of the lens caused by a perforating wound of the capsule around the eye’s lens. IIEI&H

19. Zonular Cataract Zonular cataract (lamellar cataract; perinuclear cataract) is the most common cataract in children. It may be inherited through dominant genes, or caused by malnutrition during pregnancy or early infancy. IIEI&H

20. Anterior polar Cataract Anterior polar cataract (including anterior pyramidal cataract) is a hereditary disorder occurring in children, and characterized by lesions with small white milky plaques in the front of the lens. IIEI&H

21. Posterior polar Cataract A posterior polar cataract is a round, discoid, opaque mass (see the image below) that is composed of malformed and distorted lens fibers located in the central posterior part of the lens. IIEI&H

22. Question Please…… ? . . IIEI&H

23. IIEI&H