Senile Cataract by Dr Nikhil Bansal

1. Senile cataract
 Presented by:- Dr Nikhil Bansal
J.N.M.C.,Wardha

2. General Concepts
 Almost universal in people over
70 years of age.
 Occurs equally in men and
women.
 Considerable genetic influence.
 Average age of onset is earlier
in tropical countries.

3. Types of Senile cataract
1. Cortical cataract
2. Nuclear or sclerotic cataract

4. Cortical cataract
Etio-pathogenesis:- Hydration followed
by coagulation of lens proteins in the
cortex.
Features:- Occurs in following stages :-
1. Stage of lamellar separation
2. Stage of incipient cataract
3. Immature senile cataract
4. Mature senile cataract
5. Hypermature senile cataract

5. Stage of lamellar separation
 Demarcation of cortical fibres owing
to their separation by fluid.
 Demonstrated by Slit-lamp
examination only.
 Characteristic grey appearance of
pupil.
 Changes are reversible.

6. Stage of Incipient cataract
 Wedge shaped opacities with clear
areas in between( Lens striae).
 Most common in periphery and lower
nasal quadrant.
 Only seen in dilated pupil.
 Irregularities in refraction, visual
deterioration and polyopia.

7. Immature senile cataract
 Opacification becomes more diffuse
and irregular.
 Lens is swollen.
 Iris shadow still visible.
 Anterior chamber becomes shallow.

8. Mature senile cataract
 Complete opacification.
 Whole cortex is involved .
 Lens appears pearly white in colour.
 Also known as ripe cataract.

9. Hyper-mature senile cataract
 Cortex is disintegrated and
transformed into pultaceous material.
Usually occurs in two forms:-
1. Morgagnian hyper–mature cataract
2. Sclerotic hyper–mature cataract

10. Morgagnian hyper–mature
cataract
 Complete cortex is liquefied and
appears milky white in colour.
 Nucleus settles at the bottom.
 Calcium deposits may also be seen
on the lens capsule.

11. Sclerotic hyper–mature cataract
 Disintegrated cortex.
 Shrunken lens.
 Wrinkled anterior capsule .
 Dense white capsular cataract in
pupillary area.
 Deep Anterior-Chamber.
 Tremulous Iris .

12. Nuclear or Sclerotic cataract
Etio-pathogenesis:- Intensification of age related
degenerative changes associated with
dehydration of and compaction of nucleus.
Features:-
 Hard cataract is formed.
 Significant increase in water insoluble protein.
 Lens becomes in-elastic and looses power of
accommodation.
 Changes begin centrally and slowly spread to
periphery.
 Deposition of pigments gives characteristic
colour to nucleus.

13. Nuclear or Sclerotic cataract

14. Other types of Nuclear or Sclerotic
cataract
cataracta brunescens cataracta nigra
Cataracta rubra

15. Complications of senile cataract
1. Phacoanaphylactic uveitis
2. Lens induced glaucoma
3. Subluxation or dislocation of lens

16. References
 Parson’s diseases of eye
 Comprehensive ophthalmology:-
Khurana and Khurana
 wikipedia.org

17. THANK-YOU