Cortical Cataracts

Question 1

Describe cortical (Cuneiform) cataract

what signs and symptoms, clinical presentation

Answer 1

• “glare” or “monocular” diplopia
• water vacoules, clefts between lens fibers
• cortical “spokes”
• lamellar separations
• punctate dots

Question 2

How does a cortical cataract form?

what happens to Na+/K+ pumps, alpha and beta crystalline fibers, # of amino acids, pH and lens size

Answer 2

• Na+/K+ pump slows. Na+ enters and brings in H2O
• H2O comes in contact with water soluble alpha and beta crystalline fibers to form opaque aggregates
• # of amino acids in lens increase decreasing pH
• Cathepsins activates and changes pH lens decreases in size

Question 3

Describe Incipient (immature) stage of cataract

What shows under the lens capsule

Answer 3

• first stage, see water vacoules under lens capsule

Question 4

Describe Intumescent (Phakomorphic/Phakogenic GLC) stage of cataract

(mature and swollen?, opacities?, does it affect VA, what phyical sign is seen on the lens, can it lead to secondary glaucoma?)

Answer 4

• mature cataract that is swollen with opacities
• VA only slightly affected
• some spoke formation
• may lead to secondary glaucoma

Question 5

Describe mature stage of cataract

describe lens size are VA’s affected

Answer 5

• all fibers opaque
• lens are starting to shrink
• VA’s are beginning to decrease

Question 6

Describe hypermature (phakolytic) stage of cataract

(What causes it, what type of cataract is this called, describe the lens, can it lead to secondary GLC, is it inflammatory?)

Answer 6

• Caused by degenerated protein leakage of liquified cortex out of lens capsule
• Called Morganian cataract (completely liquified cortex)
• smaller lens (shriveled up)
• may lead to secondary GLC
• not an inflammatory condition

Question 7

You see a water vacoules under the lens capsule. What stage cortical cataract is this?

A. Incipient
B. Intumescent
C. Mature
D. Hypermature

Answer 7

A. Incipient

Question 8

You see swollen and opacified lens fibers that have some spoke formation. VA is only slightly affected. What stage cortical cataract is this?

A. Incipient
B. Intumescent
C. Mature
D. Hypermature

Answer 8

B. Intumescent

Question 9

You see opaque fibers and the lens that starts to shrink. VA are beginning to decrease. What stage cortical cataract is this?

A. Incipient
B. Intumescent
C. Mature
D. Hypermature

Answer 9

C. Mature

Question 10

You see proteins of liquified cortex leak out of the lens capsule not caused by inflammation. The lens also appears shriveled up. VA are beginning to decrease. What stage cortical cataract is this?

A. Incipient
B. Intumescent
C. Mature
D. Hypermature

Answer 10

D. Hypermature