2011-2012 Basic and Clinical Science Course, Section 11: by James C. Bobrow MD

By James C. Bobrow MD

Experiences the anatomy, body structure, embryology and pathology of the lens. Covers the epidemiology, overview and administration of cataracts; supplies an summary of lens and cataract surgical procedure; and explores the problems and targeted events of cataract surgical procedure. final significant revision 2008 2009.

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Additional info for 2011-2012 Basic and Clinical Science Course, Section 11: Lens and Cataract (Basic & Clinical Science Course)

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Similarly, 35%- 50% of the risk of nuclear cataracts can be traced to inheritance. CHAPTER 5, Pathology • 51 A lens cortex _-fj;- Granular posterior - --Ii""'; subcapsular deposits (plaques) Figure 5-8 Poster ior subcapsular cataract (PSe ) viewed at th e slit lamp (A) and w ith indirect illumination (81 . C, Schematic of PSC. , division of elBA-GEIGY Corp. Reproduced w ith permission from Clinical Symposia. Illus tration by John A. ) Again, much of this risk seems to be accounted for by a single dominant gene.

In normal ocular development, the lens vesicle separates from the surface ectoderm (t he future corneal epithelium) at about 33 days' gestation. Peters anomaly is typically linked with the absence of this separation. It is often associated with mutations in or deletion of one allele of the genes normally involved in anterior segment development, including the transcription factors PAX6, PITX2, and FOXCl. Patients with Peters anomaly may also display the follOWing lens anomalies: adhesions between lens and cornea anterior cortical or polar cataract a misshapen lens displaced anteriorly into the pupillary space and the anterior chambe r microspherophakia Microspherophakia Microspherophakia is a developmental abnormality in which the lens is small in diameter and spherical.

Associated ocular anomalies include severe axial myopia, retinal detachment, enlarged corneal diameter, cataract, and abnormal iris transillu mination . Persistent Fetal Vasculature Persistent feta l vasculature (PFV). also known as persistent hyperplastic primary vitreous (PHPV). is a congenital, nonhereditary ocular malformation that frequently involves the lens. In 90% of patients. it is unilateral. A white, fibrous. retrolental tissue is present, often in association with posterior cortical opacification.

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