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What is a Hypermature Cataract?
Hypermature cataract is a especial type ofcataractthat go on when a ripe senile cataract is leave in - situ for some duration of time due to this the microscope stage of hypermaturity set in . Before defining hypermature cataract one should be clean about mature senile cataract .
A ripe senile cataract is that microscope stage where the opacification of the whole lens system is present . The lens is pearly white in color and is also referred as Ripe Cataract . This opacification involves biochemical mechanism like there is decrease in the crystalline crystalline lens proteins , atomic number 19 and various aminic acids while there is increase in the tightness of sodium which leads to pronounced hydration of the genus Lens leading to denaturation of lens system proteins . When this grade of MSC remains as it is for some time in the eye it becomes hypermature cataract .
Hypermature cataract basically is broadly of two types :
Morgagnian Hypermature Cataract : In few case the maturity date of whole cortex liquefies and the electron lens is converted into a bag of milky fluid . The nucleus appears chocolate-brown in coloring , becomes smaller and settles down at the bottom due to this the position of the nucleus is altered whenever there is modification in the spot of the lens . Rarely in the morgagnian cataract there might be calcium deposit on the lens matter .
Sclerotic Type Hypermature Cataract : In this case after the degree of matured senile cataract the cortex becomes degenerated and the lens is shrunken because of the leakage of water from it . The prior capsule appearswrinkledand there is a thickening present as there is proliferation of anterior mobile phone , due to this a thick whitened capsular cataract may be formed in the pupillary surface area . Due to the shrunken lens the prior bedchamber becomes rich than normal and there is presence of iridodonesis ( there are tremors in the iris ) .
Clinical Features of Hypermature Cataract
Symptoms
The symptoms run into are similar to normal mature senile cataract . These are talk about in legal brief .
Glare – One of the other symptom seen . In this the soul is intolerant of bright light like a headlight or directly staring atsunlightprecipitates this .
Polyopia – It is unilocular in nature . Polyopia think that there is doubling or trebling of the sight . This is see because of the variability in the refractile index .
Colored Halos – When there are weewee droplet present there might be splitting of light which may be perceived in the form of colored halos .
mordant Spots – Sometimes black spot are also seen by the patient role that are stationary in nature .
Deterioration of Vision – At last the feature article of cataract is loss of imaginativeness . It may begin centrally or peripheral depend upon the type .
Signs
When visual sharpness testing is done in both variants of hypermature cataract there is only perception of wanton positiveness seen .
screen for Iris Shadow – No iris shadow is construe
Distant Direct Ophthalmoscopy with Dilated Pupil – In this there is no ruby glow seen in both the type but milklike bloodless student is go out in Morgagnian and dirt white educatee in sclerotic case
Slit Lamp Examination – In morgagnian , whitish clean nucleus with brownish nucleus is catch and in Sclerotic , there is shrivelled cataractous genus Lens with thickened anterior capsule . On the basis of the slit lamp test the grading of nucleus harness is done from Grade I to Grade V.
Management
This involves operative as well as non - operative measures . Non- surgical mensuration are not of much grandness in dealing with hypermature cataract as the equipment casualty has already taken position .
Surgical measures include various case of surgeries that can be carry out . Presently phacoemulsification is the surgical intervention of choice . Other surgeries uncommitted let in small dent cataract operating room and the conventional ECCE ( Extracapsular cataract extraction ) .
In morgagnian hypermature cataract the lens is liquefied while it is shrivelled and degenerate in the sclerotic type . Glare , bleached gloriole and polyopia are the plebeian symptom seen . The discourse is completely surgical and phacoemulsification is the surgery of choice .
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