Rosette Cataract: Causes, Symptoms, Complications, And Treatment

Rosette Cataract is a common traumatic cataract. Rosette Cataract trauma can cause blunt force trauma followed by concussion and perforating injuries in the affected area, which can obstruct your retina from making a clear vision.

Traumatic cataracts can be described as the clouding of the lens that happens because of blunt trauma to the eye, head, or penetrating ocular region which can disrupt the lens fibers in your eyes. Other causes associated with the cause of Rosette Cataract can be electric shock, Infrared energy (glassblower's cataract), ionizing radiation, capsular tear, or any presence of pathologic changes in the lenticular composition.

Although capsular tear is rare to occur, it doesn't always lead to a Rosette Cataract. Even though a traumatic cataract can have a complicated medical diagnosis and treatment, careful examination and planned surgical management can simplify the whole procedure.

Depending upon the severity of the injury and time duration between the cause and occurrence of Rosette Cataract, it can be divided into two categories:

1. Early Rosette Cataract: The development of the early Rosette Cataract forms in either anterior capsule or posterior capsules. Sometimes it can be developed in both regions simultaneously. It can be detected via the formation of the small feathering lines of opacities along with the star-shaped suture line on the retina.
2. Late Rosette Cataracts: Unlike early Rosette Cataracts, late Rosette Cataracts can be seen after a long time of post-injury. The reason behind its late occurrence is that it develops deeper in the cortex and nucleus of the posterior cortex. In this, the sutural extensions are short and it is more compact.

Symptoms of Rosette Cataracts can be identical to other types of cataracts like:

• Blurred, clouded, or dim vision
• Difficult vision at night
• Light and glare sensitivity
• Need for brighter light for daily routine activities
• Hallucinations of halos around lights
• Frequent changes in the prescription of eyeglass or contact lens
• Faded color display
• Double vision from a single eye

Although, the additional symptom that differs Rosette Cataracts from the general one is the appearance of flower petals or feathery-shaped opacities which can be seen immediately or after some time of the accident.

In layman's terms, the main reason why a Rosette Cataract happens is an injury in the eye or nearby region of the eyes. But what actually happens is that the trauma that is caused by the injury leads to contrecoup or axial expansion of the lens. This trauma can create a shock or stroke situation in the retina which is known as coup ocular. The shock or the coup ocular compresses the pigmented posterior iris epithelial cells against the anterior lens capsule which forms a vossius ring on the surface of the retina.

Furthermore, as the contrecoup injury keeps generating coup ocular waves, the vossius ring can later develop into a posterior cortical opacification which is visible in the shape of a rosette or a stellate.

1. Blunt force trauma to the head: As the name suggests, any sudden or forced trauma on the head can also cause shock in the retina, leading to a Rosette Cataract. Comely this happens due to situations like motor vehicle accidents, sports injuries, physical assaults or falls for a dangerous height.
2. Ocular trauma to the eyeball Unlike head injuries, Ocular trauma can be more or less intense. Even though injuries like a poke or scratch in an eye look common they can lead to severe injuries. Here are some of the common reasons behind Ocular trauma
   • Corneal abrasion: Comely known as Scratched eye, corneal abrasion is the damage caused on the surface of the eye. It can happen due to poking of your finger or external object or rubbing your eyes in the presence of external pathogens like dust, bacteria, or fungus.
   • Penetration of foreign objects: Most cases of Rosette Cataracts do not show any penetration beyond the top layer or cornea of the eye, which can be easily treated, but if the object is tried to be removed without any medical procedure it can leave small slivers in your eye. Especially objects which are made with metal or wood can also leave corneal foreign bodies.
   • Eye swelling: Eye swelling is also known as the black eye can be caused due to trauma associated with fast-moving objects which can lead to coup ocular.
   • Traumatic iritis: One of the most common causes of late Rosette Cataracts, a trauma in the iritis can be seen after a common ocular trauma like corneal abrasion or Penetration of foreign objects.
   • Hyphema: Also known as blowout fracture can be a result of facial bone fracture which is surrounding your eyeballs. It can also cause sudden bleeding between Cornea and iris.
3. Subconjunctival hemorrhage or eye-bleeding: Sudden damage of one or more blood vessels between the sclera ( the white of the eye) and conjunctiva (its clear covering) can lead to the secretion of the blood into the white sclera. Unlike any other eye injury, subconjunctival hemorrhage can be painless and easily cured if detected on time.
4. Exposure to radiation: Radiations coming from any electronic device can be harmful in the longer run. One of the most common radiation is Ultraviolet or UV radiation, which can cause slow but long-lasting damage to your retina and cornea.
5. Electrocution: Ocular trauma caused due to sudden electric shock nearby or in the eye region can lead to a Rosette Cataract. The cases of electrical cataracts are few because the survival rate after getting in contact with a high voltage of current is very low. Also, eyes burn, melt, or pop out have a higher probability than cataracts. Looking directly into the thunderstorm, electrocution or electric shock therapy can be reasons behind the injury.
6. Chemical burns: A sudden splash or spray or chemical substance like acid or alkali can cause serious damage to the retina and sclera. It can also be caused by rubbing chemical-infused cloth or hands to the eye. In most cases, chemical burns can be cured easily without any complications.

• Age: As we grow, the organs may lose their strength, older people have more probability of cataracts than the younger ones, even in the case of Rosette Cataracts, the trauma will be less effective if your eyes are healthy and young.
• Diseases: illnesses like diabetes, obesity, and high blood pressure can increase the risk of cataracts in an individual.
• UV ray exposure: excessive exposure to UV rays via sunlight or your devices can be damaging to your eyesight.
• Regular consumption of alcohol and smoking: can weaken your immune system.
• Previous eye injury, inflammation, or surgery: Previous injury, inflammation, or surgery can make your eyes more prone to external illnesses like cataracts.
• Prolonged use of corticosteroid medications: prolong or excessive consumption of corticosteroid medications can increase inflammation and put pressure on your eyes ( glaucoma), clouding on the lenses on one or both of the eyes (cataracts) or increasing the risk of bacterial, and fungal infections.

Rosette Cataract Treatment can be complicated if not treated on time. Here are some methods of treatments that can be recommended by your medical professional

1. Medical Care: Depending upon the root cause of your optic trauma, Rosette Cataracts can be treated with medical care. For instance, if the cause of the trauma is your lens or the presence of iritis, adding corticosteroids to your lens can be beneficial.
2. Surgical Care: Traumatic cataracts may need surgery in most cases, especially the zonular stability and preoperative capsular integrity. Surgery will not be advised in case of posterior dislocation without the presence of inflammation, glaucoma, or visual obstruction. Here are some of the situations of Rosette Cataracts that may need surgery for treatment:
   • Uncomfortable decreased vision.
   • Obstruction in posterior pathology.
   • Lens-induced inflammation.
   • Glaucoma.
   • Lens swelling due to capsular rupture.
   • Other ocular traumas need immediate surgery.

Standard surgery like Pars plana lensectomy, vitrectomy, and phacoemulsification may be performed in case the lens capsule is intact and sufficient zonular support remains.

Other procedures like Intracapsular cataract extraction can be conducted in cases of anterior dislocation or extreme zonular instability as it can lead to pupillary block glaucoma. Both procedures can be done at any age of the patient.

Automated irrigation/aspiration is the method of treatment that can be age-specific as it includes lens implantations. Patients below the age of 35 can go for the method of treatment.

Unexpected trauma cannot be avoided as it can be accidental, although it can be avoided by some certain prevention methods like:

1. Regular checkups: Eye examinations on a regular basis can help you detect any blood leakage or damage in or behind the eyes at the early stages. Your medical advisor will let you know about the frequency of your eye examinations.
2. Wear protective gear: It is important to prevent your eyesight from the external factors like sun rays or UV rays of your digital device. Wearing sunglasses, lenses, or glasses that block ultraviolet B (UVB) rays can be a good idea.

Other alternative preventions that may help you to prevent cataract in general includes:

1. Avoid consumption of alcohol or tobacco: Both of the substances can damage your eyesight in the long run which can cause cataracts.
2. Diet alteration: Choosing a diet enriched with vitamins, nutrients, and antioxidants that can boost your immunity can prevent your eye from late Rosette Cataracts. It also helps you to manage other health problems that can increase the risk of cataracts.

Summary: A common traumatic cataract, Rosette Cataract can be described as the clouding of the lens that happens because of blunt trauma to the eye, head, or penetrating ocular region which can disrupt the lens fibers in your eyes. It is generally caused by a sudden trauma or injury in or around the eyes.