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PHOTO ESSAY
Year : 2022  |  Volume : 2  |  Issue : 3  |  Page : 812-813

Enoki mushroom like traumatic cataract


1 Consultant Cataract and Glaucoma Services, ASG Eye Hospital, Kolkata, West Bengal, India
2 Glaucoma Services, Aravind Eye Hospital, Pondicherry, India
3 Resident, General Ophthalmology, Indira Gandhi Govt. General Hospital and Post Graduate Institute, Pondicherry, India

Date of Submission29-Dec-2021
Date of Acceptance22-Mar-2022
Date of Web Publication16-Jul-2022

Correspondence Address:
Dr. Annamalai Odayappan
Aravind Eye Hospital, Cuddalore Main Road, Thavalakuppam, Pondicherry - 605 007
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3200_21

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  Abstract 


Keywords: Enoki mushroom, injury, traumatic cataract


How to cite this article:
Nath M, Odayappan A, Nachiappan S. Enoki mushroom like traumatic cataract. Indian J Ophthalmol Case Rep 2022;2:812-3

How to cite this URL:
Nath M, Odayappan A, Nachiappan S. Enoki mushroom like traumatic cataract. Indian J Ophthalmol Case Rep [serial online] 2022 [cited 2022 Aug 11];2:812-3. Available from: https://www.ijoreports.in/text.asp?2022/2/3/812/351179



A 23-year-old male came to our hospital complaining of defective vision and glare in his right eye (OD) for 6 months. He had a history of blunt trauma to his OD a few years back when he got injured by a fist. His best-corrected visual acuity was 6/9 in OD and 6/6 in the left eye. His intraocular pressure was normal in both eyes. Slit-lamp evaluation revealed a peculiar type of cataract in the OD. There was anterior subcapsular cataract with multiple mushroom-like projections from its surface (Enoki mushroom-like cataract) [Figure 1]. Enoki mushrooms or Enokitake are edible mushrooms with thin stems and small caps on top and are predominantly used in soups. Gonioscopy showed open angles with no angle recession, and fundus examination was normal. He had no systemic illness, and basic systemic work-up comprising a complete blood count, blood sugar, renal function test, and fasting lipid profile was within normal limits. As he was symptomatic, a routine uncomplicated phacoemulsification was performed. Care was taken to avoid disrupting the projections during the initiation of capsulorrhexis.
Figure 1: (a) Diffuse illumination image showing the mushroom-like anterior subcapsular opacities. (b) High-magnification image showing anterior subcapsular cataract (red arrow) with mushroom-like projections from its surface (yellow arrow). (c) Slit-lamp image in extreme lateral gaze showing the projections casting shadows (arrow). (d) The subcapsular nature of the cataract is noted intraoperatively after capsulorrhexis

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  Discussion Top


Blunt trauma can result in coup and contrecoup injury to the lens. There is also sudden anteroposterior compression of the eyeball with equatorial expansion. This stretching can disrupt the lens capsule and the zonules. A coup injury can lead to direct damage to the lens capsule. In a contrecoup injury, there are shock waves traveling within the eye, and these shock waves lead to cortical opacification.[1] The explanation is that trauma-related dysfunctional lens epithelium results in swelling of the superficial cortical lens fibers which later undergoes degeneration. Consequently, there is a lamellar zone of vacuolation and opacity formation. With time, as new clear lens fibers form, these opacities become separated from the subcapsular area and become deeper.[2],[3] It is possible that in our patient, the degenerated lens fibers got pushed up rather than deeper by the new lens fibers, leading to focal elevations resembling the mushrooms. This image is presented because of the distinctive nature of the cataract.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Singh RB, Thakur S, Ichhpujani P. Traumatic rosette cataract. BMJ Case Rep 2018;11:e227465.  Back to cited text no. 1
    
2.
Asano N, Schlötzer-Schrehardt U, Dörfler S, Naumann GO. Ultrastructure of contusion cataract. Arch Ophthalmol 1995;113:210-5.  Back to cited text no. 2
    
3.
Gumus K, Kiratli H, Yuruker S. Ultrastructural study of a contusion cataract. Indian. J Ophthalmol 2006;54:215-6.  Back to cited text no. 3
    


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