Lens Findings

Question 1

Normal Lens Findings

Answer 1

Mittendorf’s Dot and Epicapsular Stars

Question 2

Mittendorf’s Dot

Answer 2

Found nasally. 
Always nasal to visual axis. 
Embryological remnant of hyaloid artery attached to posterior lens capsule. 
Either unilateral or bilateral. 
Does NOT effect vision of patient.
direct: appears white
retro: appears black

Question 3

Epicapsular Stars

Answer 3

Small light brown/tan dots or star-shaped deposits on the anterior lens capsule.
Cluster of pigments stuck on anterior capsule.
Unilateral or bilateral.
Remnants of tunica vasculosa lentis.
Does NOT effect vision.

Question 4

Congenital Lens Opacities (Cataracts)

Answer 4

• Anterior Axial Embryonic
• Anterior and Posterior Polar
• Sutural
• Pulverrulent (Dust-like)
• Currulean “Blue Dot” Cataracts

Question 5

Anterior Axial Embryonic

Answer 5

Found in 25% of pop. 
Opacities from a twin blade propeller shaped cluster in the embryonic nucleus. 
NO VA reduction! 
Can cause glare, esp. at night.
Always anterior. 
Either unilateral or bilateral.

Question 6

Anterior and Posterior Polar

Answer 6

Can reduce VA (dependent on size)
Will see a dark spot with retro of lens – take out of click and will see the anterior polar cataract.
If big enough will go through capsule.
Retro will determine effect on VA.

Question 7

Sutural

Answer 7

Rarely effect vision unless very large and severe.

opacity is in shape of Y suture.

Question 8

Pulverulent (Dust-like)

Answer 8

Particles confined in the nucleus of lens.
Retro to know what extent it will effect patient’s vision.
Cause glare at night and inability for 20/20 vision.
Reflection comes back as white.
If seen in older patient – with yellowing lens – still congenital (yellowing of lens has to do with age).

Question 9

Currulean “Blue Dot” Cataracts

Answer 9

Peripheral cortex
Dots lie in the cortex not the nucleus.
Does NOT effect VA.
Small bluish punctate opacities of the peripheral cortex (anterior &/or posterior).

Question 10

Cataracts (definition)

Answer 10

term restricted to those opacities that are severe enough to impair visual acuity.