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CONGENITAL CATARACT - PowerPoint PPT Presentation


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CONGENITAL CATARACT. 1. Important facts. 2. Classification. 3. Causes. In healthy neonates. In unwell neonates. Important facts. 33% - idiopathic - may be unilateral or bilateral 33% - inherited - usually bilateral 33% - associated with systemic disease - usually bilateral

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Presentation Transcript
slide1

CONGENITAL CATARACT

1. Important facts

2. Classification

3. Causes

  • In healthy neonates
  • In unwell neonates
slide2

Important facts

  • 33% - idiopathic - may be unilateral or bilateral
  • 33% - inherited - usually bilateral
  • 33% - associated with systemic disease - usually bilateral
  • Other ocular anomalies present in 50%
slide3

Classification of congenital cataract

Anterior polar

Posterior polar

Coronary

Cortical spoke-like

Sutural

Focal dots

Lamellar

Central pulverulent

slide4

Anterior polar cataract

May be dominant inheritance

Capsular

Pyramid

With persistent pupillary

membrane

With Peters anomaly

slide5

Posterior polar cataract

  • Ocular associations
  • Persistent hyaloid remnants
  • Posterior lenticonus
  • Persistent hyperplastic primary vitreous
slide6

Coronary (supranuclear) cataract

Usually sporadic

  • Round opacities in deep cortex
  • Surround nucleus like a crown
slide7

Cortical spoke-like cataract

  • Systemic associations
    • Fabry disease
    • Mannosidosis
slide8

Lamellar cataract

Usually dominant inheritance

  • Systemic associations
  • Galactosaemia
  • Hypoglycaemia
  • Hypocalcaemia
  • Round central shell-like opacity
  • surrounding clear nucleus
  • May have riders
slide9

Central pulverulent cataract

Dominant inheritance

  • Spheroidal opacity within nucleus
  • Relatively clear centre
  • Non-progressive
slide10

Sutural cataract

Usually X-linked inheritance

Opacity follows shape of Y suture

slide11

Focal dot opacities

  • Blue dot cortical opacities
  • Common and innocuous
  • May co-exist with other opacities
slide12

Causes of cataract in healthy neonate

  • Hereditary
  • (usually dominant)
  • Idiopathic
  • With ocular anomalies
    • . PHPV
    • Aniridia
    • Coloboma
    • Microphthalmos
    • Buphthalmos
slide13

Causes of cataract in unwell neonate

  • Intrauterine infections
    • Rubella
    • Toxoplasmosis
    • Cytomegalovirus
    • Varicella
  • Metabolic disorders
    • Galactosaemia
    • Hypoglycaemia
    • Hypocalcaemia
    • Lowe syndrome