Traumatic cataract is an opacification of the eye's normally clear lens due to various kinds of physical and electrical injury, as well as radiation exposure. Trauma is one of the acquired causes of cataracts, but they may also be congenital. The classification of traumatic cataracts usually entails a description of their location and shape.
A history of trauma is necessary but may not be recent, as cataracts often develop slowly, and may appear years after the incident. Traumatic cataracts can be unilateral or bilateral. Injury due to blunt trauma is most commonly encountered, although penetrating trauma and other non-mechanical agents can also cause them  . Children constitute a sizable proportion of the population affected, and it has been reported that males are significantly more at risk than females  . The most frequent patterns of injury seen also vary between different age groups, with children more likely to be injured during play, and young adults during sports. The same applies for residence, as certain types of injuries are more likely to occur in rural rather than urban areas, for instance, accidental injury while collecting wood  .
Signs of traumatic cataracts are generally the same as those seen in other types of cataracts, with complaints of several visual disturbances such as blurred vision, diplopia, reduced day or night vision, and eventually blindness. The classical shape of trauma related cataracts is rosette or stellate, however traumatic cataracts are not limited to this configuration, given the possible mechanisms of the trauma . On account of the etiology of these cataracts, in addition to the above problems, many patients also have concurrent damage to other ocular, orbital and cranial structures and the severity is often proportional to the force imparted .
Entire Body System
- Juvenile Cataract
H26 Other cataract Excludes1 congenital cataract ( Q12.0 ) H26.0 Infantile and juvenile cataract H26.00 Unspecified infantile and juvenile cataract H26.001 Unspecified infantile and juvenile cataract, right eye H26.002 Unspecified infantile and juvenile [icd10coded.com]
cataract H26.09 Other infantile and juvenile cataract H26.1 Traumatic cataract H26.10 Unspecified traumatic cataract H26.11 Localized traumatic opacities Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10 [icd10data.com]
Malformations and Abnomalities Conjunctiva Cornea Glaucomas, Ocular Hypertension Hypertensive Retinopathy Iris and Ciliary Body Lacrimal System Lens Anatomy and Embryology Cataract and Associated Systemic Diseases (see: Systemic Diseases) Congenital and Juvenile [atlasophthalmology.net]
cataract on one or both sides may be noted. [en.wikipedia.org]
- Corneal Opacity
Good visual acuity was achieved in a large proportion of the children despite associated corneal opacities and several intraoperative and postoperative complications. [ncbi.nlm.nih.gov]
A 38.5% patients had corneal opacity among penetrating injury patients. The interval between trauma and surgery was less than one month among 75% of patients. After three months of surgery, 43.7% patients had visual acuity of 6/18. [jcdr.net]
Both eyes should be examined carefully for signs such as a peaked pupil, iris/uveal prolapse, a collapsed anterior chamber, ocular hypotony, diffuse bloody chemosis or vitreous hemorrhage, which may indicate a ruptured globe. [healio.com]
- Kayser-Fleischer Ring
Chalcosis is the deposition of copper in the eye It is characterized by formation of kayser fleischer ring in the cornea, cataracts ( anterior sunflower cataract ) and degenerative retinopathy. [webeyeclinic.com]
The next step is a thorough ophthalmological exam, ranging from testing visual acuity using the Snellen chart and the range of eye movements to visualizing the eyes' structures through an ophthalmoscope; which may show abnormalities in the red reflex. A slit lamp examination, if available, is best for a more detailed inspection of ocular contents and a clearer view of cataracts. Furthermore, a complete physical examination is important, with emphasis on searching for signs of cranial nerve injury, fractures, intracranial and periorbital hemorrhage.
Imaging studies are necessary, to evaluate the extent of ocular damage and to reveal any foreign bodies that may have been missed. The techniques of ultrasound, computerized tomography (CT) scan and magnetic resonance imaging (MRI) scan are often employed, as they are all useful and have their own advantages  . Ultrasound is ideal for assessing intraocular damage as well as detecting foreign bodies, while CT scans show fractures in the orbits and cranium . MRI scans may be used to detect non-magnetic foreign bodies.
Routine blood tests including a full blood count, complete metabolic panel and clotting studies can be done if surgery is anticipated.
A 58-year-old male was injured by acupuncture needle during acupuncture treatment for his cerebral infarction. [ncbi.nlm.nih.gov]
Treatment of Traumatic Cataract is the same as treatments of other types of cataract but we have to make sure to treat other complications of trauma such as eyelid laceration, corneal wounds, Hyphema and retinal injuries. [webeyeclinic.com]
CONCLUSION: Closed-globe injury has more favourable prognosis for the satisfactory ( 20/60) visual recovery after effective management of traumatic cataracts in children. [ncbi.nlm.nih.gov]
The management of such cases is an important problem in Ophthalmology and prognosis is variable. [ijo.in]
Prognosis The prognosis is dependent on the extent of the injury. Patient Education Protective eyewear is important in high-risk activities to avoid injury. For patient education resources, see the Eye & Vision Center as well as Cataracts. [emedicine.medscape.com]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Use Additional Use Additional Help Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10data.com]
These data suggest that the model of the system's loss of control on the elongation of the eye may provide valuable information and a precise direction for research on etiology and control of myopia. [ncbi.nlm.nih.gov]
Etiology and pathogenesis CATARACT TRAUMATIC (CATARACTA TRAUMATICA) The violation of the integrity of the lens bag with injuries of the eye, usually perforated. Symptoms and course CATARACT TRAUMATIC (CATARACTA TRAUMATICA) Symptoms. [lecheniebolezni.com]
Institute, Qingdao, Shandong Province, China Yu-Sen Huang Shandong Eye Institute, Qingdao, Shandong Province, China Li-Xin Xie Shandong Eye Institute, Qingdao, Shandong Province, China Hits : 2420 Download times : 584 Abstract: AIM: To evaluate the etiologies [ijo.cn]
The epidemiology and diagnosis of penetrating eye injuries. Acad Emerg Med. 2002 Mar;9(3):209–13. Reddy AK, Ray R, Yen KG. Surgical intervention for traumatic cataracts in children: epidemiology, complications and outcomes. [medresearch.in]
LEVEL OF EVIDENCE: Epidemiologic study, level IV. [ncbi.nlm.nih.gov]
The epidemiology of ocular trauma in rural Nepal. Br J Ophthalmol. 2004; 88:456-60. Abraham, D. I.; Vitale, S. I.; West, S. I.; Isseme, I. Epidemiology of eye injuries in rural Tanzania. Ophthalmic Epidemiol.1999; 6:85-94 D. Virgil Alfaro, Eric P. [eyewiki.aao.org]
Epidemiology Frequency United States Approximately 2.5 million eye injuries occur annually in the United States. It is estimated that approximately 4-5% of a comprehensive ophthalmologist's patients are seen secondary to ocular injury. [emedicine.medscape.com]
Pathophysiology Blunt trauma is responsible for coup and contrecoup ocular injury. Coup is the mechanism of direct impact. [eyeglobe-eyeglobe.blogspot.com]
Careful examination and a management plan can simplify these difficult cases and provide the best possible outcome. [5, 6] Pathophysiology Blunt trauma is responsible for coup and contrecoup ocular injury. Coup is the mechanism of direct impact. [emedicine.medscape.com]
The need for adequate health education to prevent ocular injuries and preoperative diagnosis of associated posterior segment complications that may prevent optimal post-operative visual acuity is also noted. [ncbi.nlm.nih.gov]
- Khatry SK, Lewis AE, Schein OD, et al. The epidemiology of ocular trauma in rural Nepal. Br J Ophthalmol. 2004;88(4):456–460.
- Singh D, Singh K, Singh J, Sood R. The role of intraocular lens in traumatic cataract. Indian J Ophthalmol. 1983;31(3):294–297.
- Smith D, Wrenn K, Stack LB. The epidemiology and diagnosis of penetrating eye injuries. Acad Emerg Med. 2002;9(3):209–213.
- Cillino S, Cassiccio A, Di Pace F, Pilliteri F, Cillino G. A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area. BMC Ophthalmol. 2008;8:6.
- Shah M, Shah S, Shah S, Prasad V, Parikh A. Visual recovery and predictors of visual prognosis after managing traumatic cataracts in 555 patients. Ind J Ophthalmol. 2011;59(3):217–222.
- Shah MA, Shah SM, Shah SB, et al. Morphology of traumatic cataract: Does it play a role in final visual outcome? BMJ Open. 2011;1(1):e000060.
- Kumar A, Kumar V, Dapling RB. Traumatic cataract and intralenticular foreign body. Clin Exp Ophthalmol. 2005;33(6):660-661.
- Yang B, Shan L, Song W, et al. Copolymer-1 immunization reduces damage in retinal ganglion cells under high intraocular pressure through altering the expression of retinal neurotrophins. J Ocul Pharmacol Ther. 2010;26(1):11-19.