Wahid Heru Widodo

Department of Ophthalmology
Margono Soekarjo General Hospital
THE CRYSTALLINE LENS

 CAPSULE
 NUCLEUS
 CORTEX
 ZONULAR FIBERS
 ACCOMMODATION
PHYSIOLOGY OF SYMPTOMS

 Symtomps of visual disorders  visual

 Presbiopic symtomps
 Aphakic refractive state
 CATARACT
 A Cataract is any opacity in the lens

 Caused by : aging, trauma, toxins, systemic

diseases
 Pathogenesis is not completely understood
 Age-related cataract :
- 50% in individuals aged 65-74
- 70% in individuals aged over 75
AGE RELATED CATARACT
NUCLEAR CATARACT
 Myopic shift in refraction
 Monocular diplopia

CORTICAL CATARACT
 Glare

SUBCAPSULAR POST CATARACT

 Decreased visual acuity
 Glare
AGE-RELATED CATARACT

 IMMATURE CATARACT

 MATURE CATARACT

 HYPERMATURE CATARACT
CHILDHOOD CATARACT

 Congenital
 Acquired
CAUSED BY :
 Hereditary
 Metabolic
 Infectious diseases
 Associated with syndromes
 Trauma
TRAUMATIC CATARACT

 Blunt trauma
 Penetrating trauma
 Ionizing radiation
 Overexposure to heat
COMPLICATED CATARACT

Secondary to intraocular diseases

 uveitis
 glaucoma
 retinitis pigmentosa
 retinal detachment
CATARACT ASSOCIATED WITH
SYSTEMIC DISEASES
 Diabetes Mellitus
 Hypocalcemia
 Atopic dermatitis
 Galactosemia
 Myotonic distrophy
DRUG-INDUCED CATARACT

 Corticosteroid
 Phenothiazines
 Amiodarone
POSTERIOR CAPSULAR
OPACIFICATION (After Cataract)
 Opacification of the posterior capsule
following extracapsular cataract extraction
LENS-INDUCED UVEITIS

 Caused by : traumatic rupture of the lense or

hypermature cataract
 Signs and symptoms : red, painful eye,
chemosis, flare, keratic precipitates
LENS INDUCED GLAUCOMA
 Phacolytic glaucoma
- Denatured, liquefied lens protein leak
through an intact but permeable lens capsule

 Phacomorphic glaucoma
- Intumescent cataractous lens
MANAGEMENT OF CATARACT IN
ADULTS
 Medical management
 Low-vision Aids for Cataract
 Surgery
CATARACT SURGERY

 INTRACAPSULAR CATARACT EXTRACTION

CATARACT SURGERY

 EXTRACAPSULAR CATARACT SURGERY

CATARACT SURGERY

 PHACOEMULSIFICATION
DISLOCATED LENS

 HEREDITARY LENS DISLOCATION

 Homocystinuria
 Marfan’s syndrome

 TRAUMATIC LENS DISLOCATION

Thank you