EyeWorld Asia-Pacific December 2019 Issue

EWAP DECEMBER 2019 15 FEATURE Pannet Pangputhipong, MD Mettapracharak Hospital and Eye Institute Sampran District, Nakom Pathom Province, Thailand 73210 pannetp@hotmail.com ASIA-PACIFIC PERSPECTIVES TOP VIEW SIDE VIEW Vertical (Top - Bottom) Cracking Horizontal (Periphery - Central) Cracking Source: Pannet Pangputhipong, MD B runescent cataract is a senile cataract appearing as a brown opacity because of dense nuclear sclerosis. 4GF TGƃGZ KU NGUU UQ ECRUWNQTJGZKU YKNN DG OQTG FKHƂEWNV (QT DGVVGT XKUKDKNKV[ YG ECP KPETGCUG OKETQUEQRG NKIJV CPF WUG JKIJGT OCIPKƂECVKQP FWTKPI ECRUWNQTJGZKU QT UVCKP VJG ECRUWNG + RTGHGT VQ OCMG C NCTIGT TJGZKU s OO HQT DGVVGT OCPKRWNCVKQP FWTKPI PWENGCT TGOQXCN 6JG PWENGWU YKNN DG NCTIG JCTF CPF UQOGVKOGU NGCVJGT[ OCMKPI KV FKHƂ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progress from a brunescent cataract QT HTQO C RTGUGPKNG ECVCTCEV YKVJ NGUU FGITGG QH PWENGCT UENGTQUKU %JCNNGPIGU KP OCVWTG ECVCTCEV CTG RQQT XKUKDKNKV[ FWTKPI ECRUWNQTJGZKU CPF FKHƂ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acute angle closure glaucoma called pRJCEQOQTRJKE INCWEQOCq 6JG EJCNNGPIGU of an intumescent cataract include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ƃCV #% CPF JKIJ +12 EKNKCT[ DNQEM INCWEQOC YKVJ ƃWKF OKUFKTGEVKQP KPVQ VJG XKVTGQWU OC[ JCRRGP +P UWEJ ECUGU YG may need to perform pars plana tapping QT XKVTGEVQO[ QVJGTYKUG YG OC[ PQV DG CDNG VQ FGGRGP VJG CPVGTKQT EJCODGT +H VJG PWENGWU KU JCTF ITQQXG YKVJ $GXGN &QYP 2JCEQ CPF ETCEM YKVJ & %TCEMKPI %QPEGRV +P CP KPVWOGUEGPV ECVCTCEV VJG ECRUWNG OC[ DG VJKP CPF 6T[RCP $NWG OC[ CNUQ OCMG KV DTKVVNG UQ YG UJQWNF CXQKF UVTGVEJKPI VJG ECRUWNG FWTKPI PWENGWU OCPKRWNCVKQP UGG JVVRU [QWVW DG L)TP0:W-;M# # J[RGTOCVWTG ECVCTCEV KU VJG RTQITGUUKQP QH C OCVWTG ECVCTCEV KP YJKEJ VJG NGPU ECRUWNG KU NGCMKPI #U VKOG RCUUGU VJG ƂDTQVKE RTQEGUU YQTMU CU C UGNH RCVEJ CPF VJG NGPU ECRUWNG DGEQOGU YTKPMNGF QT UJTWPMGP 9G OC[ PGGF UEKUUQTU FWTKPI ECRUWNQTJGZKU +H VJG PWENGWU KU JCTF WUG VJG VGEJPKSWG OGPVKQPGF GCTNKGT 6JGTG OC[ DG ƂDTQUKU QH VJG RQUVGTKQT ECRUWNG VJCV PGGF RQUVGTKQT ECRUWNQTJGZKU QT RQUVQR ;#) NCUGT ECRUWNQVQO[ +P ECUGU YKVJ RJCEQN[VKE INCWEQOC KPFWEGF D[ KPƃCOOCVKQP CPF NGPU OCVGTKCN DNQEMKPI VJG VTCDGEWNCT OGUJYQTM CPVK INCWEQOC OGFKECVKQP KU IKXGP DGHQTG VJG UWTIGT[ # RTQRGT GXCNWCVKQP CPF C IQQF UWTIKECN RNCP YKNN JGNR WU UCHGN[ RCUU VJTQWIJ VJG NQPI CPF YKPFKPI TQCF 'FKVQTUo PQVG &T 2CPIRWVJKRQPI FGENCTGF PQ TGNGXCPV ƂPCPEKCN interests.