Traumatic cataracts occur secondary to blunt or penetrating ocular trauma. Lens dislocation and subluxation are found commonly in conjunction with traumatic cataract. Traumatic cataract can present many medical and surgical challenges to the ophthalmologist. Careful examination and a management plan can simplify these difficult cases and provide the best possible outcome. Blunt trauma is responsible for coup and contrecoup ocular injury.
Coup is the mechanism of direct impact.
Contrecoup refers to distant injury caused by shockwaves traveling along the line of concussion. When the anterior surface of the eye is struck bluntly, there is a rapid anterior-posterior shortening accompanied by equatorial expansion. This equatorial stretching can disrupt the lens capsule, zonules, or both. Combination of coup, contrecoup, and equatorial expansion is responsible for formation of traumatic cataract following blunt ocular injury. Penetrating trauma that directly compromises the lens capsule leads to cortical opacification at the site of injury.