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Cataracts: Before and after
Key points
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Definition: Cataracts cloud the normally clear ocular lens, block the passage of light to the retina, and cause decreased vision and blindness if untreated.
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Classic clue: An elderly patient who complains of night “glare” and decreasing vision, with a well-defined biconvex calcified disc posterior to the cornea on computed tomography (CT). It may also be a patient of any age who has received trauma to the globe and exhibits significantly decreased attenuation in that lens compared to the contralateral lens.
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Cataracts are the leading cause of blindness worldwide.
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“Don’t forget to report ‘simple’ findings on CT” or magnetic resonance imaging (MRI).
Imaging
Computed tomography features
Nontraumatic cataracts
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CT typically shows a well-defined, biconvex disc, posterior to the cornea, and has a higher than normal attenuation caused by calcification.
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Calcification may be more conspicuous if a normal contralateral lens is available for comparison.
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Calcification progresses incrementally, parallels the LOCS III (Lens Opacities Classification System III) that rates severity from 1 to 5.
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As calcification progresses, the desiccated lens margin becomes progressively more irregular.
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