0 Acquired cataract

Reactions: 
Etiology : 

  1. Senile
  2. Metabolic
  3. Complicated
  4. Toxic
  5. Traumatic
  6. Radiational


Posterior SubCapsular (PSC) -- diminishes the vision most (because it is near to nodal point)
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A.  Senile

Cortical - due to imbibition of water
Stages
Lamellar separation -->Intumuscent ---> Mature --> Hypermature (Morgagnian) --> MC Complication - Phacolytic Glaucoma

Nuclear
Nuclear Sclerosis (deposition of insoluble AA and pigments)
Immature ---> Mature---> Hypermature Nuclear sclerotic ---> MC complication -- Subluxation of lens

Secondary sight of Old Age -- Nuclear Sclerosis -- Lens Refractive index increases.

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Causes of Frequent changes of Presbiopic glasses.

  1. Intumuscent Cataract
  2. Late stage primary open angle glaucoma
  3. Diabetes (Hyperglycemia -- Myotic shift of glasses)
--------------------------------

B.  Metabolic

  1. Diabetes -- Snow Flake / Snow storm cataract , due to sorbitol accumulation ,
    enzyme involved -- NADPH dependent Aldose Reductase
  2. Galactosemia -- Oil Droplet cataract
  3. Chalcosis (Cu) -- Sunflower Cataract
  4. Lowes Syndrome -- Cataract + Posterior Lenticonus / Lentiglobus
(Anterior Lenticonus -- Alport's )

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C.  Complicated

Pathognomic feature -- Polychromatic Lustre = Bread Crum appearance.

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D. Toxic

  1. Steroids (PSC)
  2. Long acting Myotic
  3. Phenothiazines
  4. Amiodarone
  5. Busulphan
  6. Gold
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E. Traumatic

Perforating (generally Anterior Polar)

Blunt / Concussion
  1. Rossette shaped - in Anterior cortex
  2. Vossius ring (Ant Capsule).
  3. Berlin's Edema (Comotio Retinae)
    Cherry Red Spot at Macula
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F. Radiational

PSC is MC type

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ICCE as treatment is ONLY indicated in SUBLUXATION OF LENS

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T/t -- SICS , Phaco

Phaco uses Foldable IOL -- MC Acryl

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