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CONGENITAL CATARACT In healthy neonates In unwell neonates 2. Classification 3. Causes 1. Important facts
13

23Congenital Cataract

Jul 11, 2016

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Yustia Sari

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Page 1: 23Congenital Cataract

CONGENITAL CATARACT

• In healthy neonates• In unwell neonates

2. Classification

3. Causes

1. Important facts

Page 2: 23Congenital Cataract

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%

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Classification of congenital cataract

Anterior polar Posterior polar Coronary Cortical spoke-like

Lamellar Central pulverulent Sutural Focal dots

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Anterior polar cataract May be dominant inheritance

Capsular Pyramid

With persistent pupillary membrane

With Peters anomaly

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Posterior polar cataract

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

Page 6: 23Congenital Cataract

Coronary (supranuclear) cataract

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

Usually sporadic

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Cortical spoke-like cataract

Systemic associations• Fabry disease• Mannosidosis

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Lamellar cataract

Systemic associations• Galactosaemia• Hypoglycaemia• Hypocalcaemia

• Round central shell-like opacity surrounding clear nucleus• May have riders

Usually dominant inheritance

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Central pulverulent cataract

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

Dominant inheritance

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Sutural cataract

Opacity follows shape of Y suture

Usually X-linked inheritance

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Focal dot opacities

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

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Causes of cataract in healthy neonate

Hereditary (usually dominant)

Idiopathic

With ocular anomalies. PHPV• Aniridia• Coloboma• Microphthalmos• Buphthalmos

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Causes of cataract in unwell neonate

Intrauterine infections• Rubella

• Toxoplasmosis

• Cytomegalovirus

• Varicella

Metabolic disorders• Galactosaemia

• Hypoglycaemia

• Hypocalcaemia

• Lowe syndrome