What is Traumatic Cataract?
Traumatic cataract is clouding of the lens and eyes that may occur after either blunt or penetrating ocular trauma that disrupts and damages the lens fibers. Most of the traumatic cataracts lead to eye lens swelling, but the type and clinical course depends on trauma and the integrity of the capsular bag. Traumatic cataracts occur in 24% of patients with globe contusions across the globe.
A concussion cataract may occur due to and in a blunt trauma. The lens capsule is not extensively damaged but becomes progressively opaque over a period of time. The traumatic cataract pathophysiology is the direct rupture and distortion of capsule or coup, equatorial expansion due to various forces transferring the energy effect of trauma to the other side of the eye.
Traumatic Cataract Symptoms
- Discomfort and pain
- Reddish eye
- Anterior chamber cell reaction
- Corneal infection and edema
- Blurry vision
Causes of Traumatic Cataract
- Infrared lights
- Electric sparks
- Long Radiation
- Eye Rupture
- Long exposure to ultraviolet rays
- Head Injury
Risk Factors
Associated with Traumatic Cataract
- Smoking
- Drinking too much alcohol
- Spending too much time in the sun without sunglasses
- Diabetes
- A serious eye or head injury
- Any other eye condition
- Taking steroids for an extended time
- Radiation treatment for cancer or other diseases
Prevention of Traumatic Cataract
It is essential to avoid eye injuries and eye trauma by taking appropriate measures. The most important thing is to use protective eyewear, including glasses and eye shields, to prevent eye injuries in hazardous situations at work and play, not spending too much time under the influence of infrared rays, ultra violet rays etc.
Traumatic Cataract types
- Blunt Trauma: This trauma occurs when an object collides with, but does not penetrate or cut, the eye or face with a force. Some examples of blunt trauma are a punch on the eye, being hit in the eye with a ball, etc. Damage to the lens can result in either an immediate cataract or a delayed cataract causing extreme trauma.
- Penetrating Trauma: This trauma occurs when a sharp object, such as a piece of glass, a pencil, or a nail, penetrates and hits the eye. If the object goes through the cornea to the lens, a traumatic cataract is to be expected almost at the very same instant. A full rupture and damage of the lens is also possible. It may lead to partial or full cataract and blindness.
- Chemical Trauma: This type of trauma refers to the penetration of the eye by a chemical substance that is alien to the eye, resulting in a change in the overall composition of the lens fibers and leading to the cause of traumatic cataract.
- Radiation Trauma: Radiation exposure, usually common among children, can damage and rupture the lens and eye vision causing a traumatic cataract. Often, there is an extensive period between the contact and exposure to radiation and the stages of development of the cataract. The cataract is usually the aftereffect of the radiation.
Diagnosis of Traumatic Cataract:
Differential Diagnoses
- Angle-Recession Glaucoma
- Choroidal Damage
- Corneoscleral Laceration
- Ectopia Lentis
- Hyphema
- Senile Cataract (Age-Related Cataract)
- Sudden Vision Loss
Traumatic Cataract Treatment
There are two questions with respect to the surgery of traumatic cataract: Should primary or secondary cataract surgery be performed, and what is the most proper and safe technique if the surgery is needed? Conservative management with lens preservation is followed to take care and look after accommodative potential in young patients unless there is significant vision loss or complications. In eyes with existing injuries, if the lens damage is clear and extensive with cortical material in the anterior chamber, lens removal is performed at the same time as repair of the cut in the cornea, termed as the primary procedure. The secondary procedure is the method in which the corneal laceration repair is performed initially, followed by cataractous lens removal with proper time intervals. Book an appointment now.
Written by: Dr. Prathiba Surender – Head – Clinical Services, Adyar
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