Cataract classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Rohan Bir Singh, M.B.B.S.[2]

Classification

The following is a classification of the various types of cataracts. This is not comprehensive and other unusual types may be noted.

• Classified by etiology
• Age-related cataract

• Immature Senile Cataract (IMSC) - partially opaque lens, disc view hazy
• Mature Senile Cataract (MSC) - Completely opaque lens, no disc view
• Hypermature Senile Cataract (HMSC) - Liquefied cortical matter: Morgagnian Cataract

• Congenital cataract

• Sutural cataract
• Lamellar cataract
• Zonular cataract
• Total cataract
• Secondary cataract

• Drug-induced cataract (e.g. Corticosteroids)

• Traumatic cataract

• Blunt trauma (capsule usually intact)
• Penetrating trauma (capsular rupture & leakage of lens material - calls for an emergency surgery for extraction of lens and leaked material to minimize further damage)

• Classified by location of opacity within lens structure (However, mixed morphology is quite commonly seen, e.g. PSC with nuclear changes & cortical spokes of cataract)

• Anterior cortical cataract
• Anterior polar cataract
• Anterior subcapsular cataract

• Nuclear cataract - Grading correlates with hardness & difficulty of surgical removal

• 1 - Grey
• 2 - Yellow
• 3 - Amber
• 4 - Brown/Black (Note: "Black cataract" translated in some languages (like Hindi) refers to Glaucoma, not the color of the lens nucleus)

• Posterior cortical cataract
• Posterior polar cataract (importance lies in higher risk of complication - posterior capsular tears during surgery)
• Posterior subcapsular cataract (PSC) (clinically common)

• After-cataract - posterior capsular opacification subsequent to a successful extracapsular cataract surgery (usually within 3 months - 2 years) with or without IOL implantation. Requires a quick & painless office procedure with Nd:YAG laser capsulotomy to restore optical clarity.