Traumatic Cataracts: Focus On Rosette-Shaped Cataracts

The rosette-shaped cataract is an unusual variant of cataract that can appear immediately after the trauma, most commonly blunt trauma or several months or even years later, and may remain stable without significantly altering visual acuity or progressively develop into cortico-nuclear or total forms. In some cases, it can also be caused by exposure to radiation or, more rarely, in diabetic patients.

The purpose of this case report is to highlight the specific clinical and therapeutic characteristics of certain forms of traumatic cataracts, in particular rosette cataracts.

Ophthalmology B departement , CHU Ibn Sina RABAT - MOROCCO-

We report the case of a 25-year-old patient who presented for consultation with a visual blur that had been progressively developing for 1 year.

The history found that the patient had suffered eye trauma from a punch more than 4 years previously. 

Ophthalmological examination revealed visual acuity of 7/10ths on the right and 10/10ths on the left. 

Slit-lamp examination revealed a posterior subcapsular cataract with thin blades forming a rose-shape in the right eye. Examination of the dilated fundus revealed no abnormalities. Examination of the left eye was strictly normal. 

Ocular tone on the applanation tonometer was 13 mm Hg in both eyes.

A complete ophthalmological examination is essential to detect any secondary lesions resulting from trauma, including wounds, hyphema, zonular rupture, lens dislocation, angle-recession glaucoma, phacoanaphylactic uveitis, retinal or choroidal detachment, optic neuropathy or retrobulbar haemorrhage.

During surgery, it is important to handle the anterior capsule gently to minimize stress on the zonules, and phaco parameters should be decreased if zonular weakness is evident.

In our patient's case, since his visual acuity has been preserved, surgery is currently being deferred, with regular monitoring of the progress of his cataract.