Download COMPLICATED CATARACT

Prepared by
Aizuddin Hidrus
Mohd Zakariyya Bin Kamil
 It
means opacification of the lens secondary
to local(ocular) or systemic disease
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Ocular disease- disturbance of the nutrition of the lens and
accumulation of toxins in the aqueous.
The opacity usually starts in the posterior part of the cortex in
the axial region(posterior cortical) as the capsule here is very
thin and the subcapsular epithelium is absent allowing easy
passage of toxins inside the lens.
Examples:
1)perforated central corneal ulcer
2)chronic glaucoma
3)iridocyclitis
4)chorio-retinitis
5)retinal –deatchment
6)intraocular tumors
7)high myopia
8)Retinitis pigmentosa
9)Subluxation or dislocation of the lens
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1)Diabetic cataract
a)Snow flakes cataract(true diabetic cataract):
-It occurs typically in young type 1 diabetics(insulin dependent)
-It starts as “fluid vacuoles” then a cloud of opacities resembling
“snow-flakes” appear all over the lens and finally becomes
totally milky white.
b)Pre-Senile cataract:
-It stimulates senile cataract but it develops at an earlier age
2)Hypo-paratyrodism
3)Severe anemia
4)Toxic(Naphthalene,didnitrophenol,ergot,thalium, and systemic
cortisone)
5)Radiation(infra red in glass blowr cataract,x ray ,electric
cataract and ultrasonic radiation)
6)Other systemic diseases:atopic dermatitis,myotonia
dystrophica,sclerodermia,mongolism, and cretinism.)
-Positive history of ocular or systemic diseases.
 -The age may be suggestive (young age).
 -The opacity starts in the posterior subcapsular
area,shows polychromatic luster )characteristic
rainbow display of colors) seen on slit lamp
examination .
 -The opacity may progress to total opacity with
chalky white appearance (excessive calcium
deposition).
 -The eye shows sign of the original disease
e.gKPs of iridocyclitis,High intraocular pressure
or bad projection of light in retinal detachment.
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 -retinal
function should be good
 -If the opacity is total,retina cannot be seen
,so Ultrasonography is mandatory
 -Cataract extraction is done by extra
capsular cataract extraction .
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