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CONGENITAL CATARACT

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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CONGENITAL CATARACT

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  1. CONGENITAL CATARACT 1. Important facts 2. Classification 3. Causes • In healthy neonates • In unwell neonates

  2. 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%

  3. Classification of congenital cataract Anterior polar Posterior polar Coronary Cortical spoke-like Sutural Focal dots Lamellar Central pulverulent

  4. Anterior polar cataract May be dominant inheritance Capsular Pyramid With persistent pupillary membrane With Peters anomaly

  5. Posterior polar cataract • Ocular associations • Persistent hyaloid remnants • Posterior lenticonus • Persistent hyperplastic primary vitreous

  6. Coronary (supranuclear) cataract Usually sporadic • Round opacities in deep cortex • Surround nucleus like a crown

  7. Cortical spoke-like cataract • Systemic associations • Fabry disease • Mannosidosis

  8. Lamellar cataract Usually dominant inheritance • Systemic associations • Galactosaemia • Hypoglycaemia • Hypocalcaemia • Round central shell-like opacity • surrounding clear nucleus • May have riders

  9. Central pulverulent cataract Dominant inheritance • Spheroidal opacity within nucleus • Relatively clear centre • Non-progressive

  10. Sutural cataract Usually X-linked inheritance Opacity follows shape of Y suture

  11. Focal dot opacities • Blue dot cortical opacities • Common and innocuous • May co-exist with other opacities

  12. Causes of cataract in healthy neonate • Hereditary • (usually dominant) • Idiopathic • With ocular anomalies • . PHPV • Aniridia • Coloboma • Microphthalmos • Buphthalmos

  13. Causes of cataract in unwell neonate • Intrauterine infections • Rubella • Toxoplasmosis • Cytomegalovirus • Varicella • Metabolic disorders • Galactosaemia • Hypoglycaemia • Hypocalcaemia • Lowe syndrome

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