Cataracts II - Corralliform to Lamellar Cataract

Question 1

Describe coralliform

What it is, any distinct shape, does it affect vision?

Answer 1

• aggregated sutural opacities
• irregular coral shape
• may or may not affect vision

Question 2

Describe Persistent hyperplastic primary vitreous (PHPV)

Age onset, what causes it, what happens to lens, any distinct signs

Answer 2

• onset 7th month
• hyaloid vasculosa (Primary vitreous) persists and counteracts growth
• lens is small, opaque and vascularized
• leukocoria (white pupil) can result
• has mittendorf dot

Question 3

Describe Tunica vasculosa lentis

(unilateral/bilateral, associations?, describe the lens, how it affects IOP, what is seen through dilated pupil, what diagnostic test is used to confirm cataract

Answer 3

• unilateral
• associated with micropthalmos
• cataractous lens
• high IOP
• elongated ciliary processes are visible
• use B-scan to confirm cataract

Question 4

Describe lens coloboma

What fails to form and how does it affect the lens, what disease may cause it to form?

Answer 4

• zonules fail to form causing the lens to become subluxated

- may form due to iris coloboma or Marfan’s syndrome

Question 5

Describe lamellar (Zonule) cataract

how does Ca2+ impact it, what happens to the size of the opacity with age, how does it appear

Answer 5

• due to Calcium levels dropping and the restoring
• lens capsule allows water intake and lens fibers to opacify. new fibers become clear
• opacity is larger in young children and becomes smaller with age as it pushes towards center
• may appear as spokes

Question 6

You see a patient with a sutural opacity that appears irregular “coral shape”. What is the cataract?

A. Lamellar Cataract
B. Coralliform
C. Lens Coloboma
D. Persistent Hyperplastic Primary Vitreous
E. Tunica Vasculosa Lentis

Answer 6

B. Coralliform

Question 7

You have a patient that has a small, opaque and vascularized lens that appears to have a dot on the posterior section. You also notice a white pupil (leukocoria) upon examination but no cataract. What is the diagnosis?

A. Lamellar Cataract
B. Coralliform
C. Lens Coloboma
D. Persistent Hyperplastic Primary Vitreous
E. Tunica Vasculosa Lentis

Answer 7

D. Persistent Hyperplastic Primary Vitreous

Question 8

You have a patient that has micropthalmos and high IOP only in their right eye. You also see elongated ciliary processes through their pupil and what appears to be a cataract. A B-scan confirms this. What is your diagnosis?

A. Lamellar Cataract
B. Coralliform
C. Lens Coloboma
D. Persistent Hyperplastic Primary Vitreous
E. Tunica Vasculosa Lentis

Answer 8

E. Tunica Vasculosa Lentis

Question 9

When the tertiary vitreous (zonules) fail to form, causing the lens to subluxate. What is the diagnosis?

A. Lamellar Cataract
B. Coralliform
C. Lens Coloboma
D. Persistent Hyperplastic Primary Vitreous
E. Tunica Vasculosa Lentis

Answer 9

C. Lens Coloboma

Question 10

A child has a lens with a large opacity that appears as “spokes/riders”. Over time, the opacity has become smaller and moved more towards the center of the lens. What is the diagnosis?

A. Lamellar Cataract
B. Coralliform
C. Lens Coloboma
D. Persistent Hyperplastic Primary Vitreous
E. Tunica Vasculosa Lentis

Answer 10

A. Lamellar Cataract