Traumatic Cataract Clinical Presentation

Updated: Sep 20, 2018
  • Author: Robert H Graham, MD; Chief Editor: Hampton Roy, Sr, MD  more...
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Note the following:

  • Mechanism of injury - Sharp versus blunt

  • Past ocular history - Previous eye surgery, glaucoma, retinal detachment, diabetic eye disease

  • Past medical history - Diabetes, sickle cell, Marfan syndrome, homocystinuria, hyperlysinemia, sulfate oxidase deficiency

  • Visual complaints - Decreased vision (cataract, lens subluxation, lens dislocation, ruptured globe, traumatic optic neuropathy, vitreous hemorrhage, retinal detachment); monocular diplopia (lens subluxation with partial phakic and aphakic vision); binocular diplopia (traumatic nerve palsy, orbital fracture); pain (glaucoma secondary to hyphema, pupillary block, or lens particles; retrobulbar hemorrhage; iritis)



Complete ophthalmic examination (defer in case of globe compromise), to include the following:

  • Vision and pupils - Presence of afferent pupillary defect (APD) indicative of traumatic optic neuropathy

  • Extraocular motility - Orbital fractures or traumatic nerve palsy

  • Intraocular pressure - Secondary glaucoma, retrobulbar hemorrhage

  • Anterior chamber - Hyphema, iritis, shallow chamber, iridodonesis, angle recession

  • Lens - Subluxation, dislocation, capsular integrity (anterior and posterior), cataract (extent and type), swelling, phacodonesis

  • Vitreous - Presence or absence of hemorrhage, posterior vitreous detachment

  • Fundus - Retinal detachment, choroidal rupture, commotio retinae, preretinal hemorrhage, intraretinal hemorrhage, subretinal hemorrhage, optic nerve pallor, optic nerve avulsion



Traumatic cataracts occur secondary to blunt or penetrating ocular trauma.



Lens dislocation and subluxation are commonly found in conjunction with traumatic cataract. [4]

Other associated complications include the following: phacolyticphacomorphic, pupillary block, and angle-recession glaucoma; phacoanaphylactic uveitis; retinal detachment; choroidal rupturehyphema; retrobulbar hemorrhage; traumatic optic neuropathy; and globe rupture. [5]