Traumatic Cataract case

An 11 year-old male was referred to the University of Iowa Hospitals and Clinics for evaluation of a possible open globe. One day prior, while hammering on a taillight of an old automobile a glass shard flew into his right eye.

The boy complained of pain and a foreign body sensation and was taken to the local emergency treatment center for evaluation. A slit lamp examination failed to reveal a foreign body. Early the next morning he awoke with worsening pain and decreased vision.

A local ophthalmologist noted a corneal laceration and cataract, but could not rule out the presence of an intraocular foreign body and referred him to the UIHC.


Upon arrival, he continued to complain of pain and decreased vision in his right eye.


Past Ocular History: No prior ocular injury, surgery, or illness.

Exam, Ocular:

Visual Acuity, without correction: right eye (OD)--20/70; left eye (OS)--20/20

Motility: Normal; no restrictions

Intra-ocular pressure: OD -- 15; OS not attempted due to risk of open globe

Pupils: No relative afferent pupillary defect RAPD

Slit lamp examination, OD:

full- thickness stellate corneal laceration

.(Seidel negative)

Anterior chamber - deep with 1+ cell and flare

Anterior capsular tear - from 11:00 to 4:00 position and extending to the zonules

Cortical lens material protruding through the tear

Dilated fundus exam (DFE): Noforeign body. No vitreous hemorrhage or vitritis. Normal macula, vessels, and periphery, OU

Diagnosis: Self-sealing corneal laceration with traumatic cataract and anterior capsular rupture

Medications: Gatifloxacin (Zymar) ophthalmic drops, 4x/day, in the right eye