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
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]
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]
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.
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