## Cataract Maturity Classification **Key Point:** Cataracts are classified based on their degree of opacity and clinical appearance. A mature cataract represents complete lens opacification with loss of red reflex. ### Classification of Cataract Maturity | Stage | Appearance | Red Reflex | Anterior Chamber | Vision | |-------|-----------|-----------|------------------|--------| | **Immature** | Partial opacity, cortical involvement | Present | Normal | > 6/60 | | **Mature** | Complete white opacity, milky-white nucleus | Absent | Normal | < 6/60 | | **Intumescent** | Swollen lens, increased thickness | Absent | Shallow | Rapidly declining | | **Hypermature** | Wrinkled capsule, sunken nucleus | Absent | Deep | Severe vision loss | ### Mature Cataract Features 1. **Appearance** — completely white, opaque lens with no red reflex 2. **Nucleus** — milky-white, hard, and dense 3. **Cortex** — completely involved with opacification 4. **Vision** — severely reduced (< 6/60 or counting fingers) 5. **Anterior chamber** — normal depth (unlike intumescent) 6. **Surgical readiness** — ideal stage for cataract extraction **High-Yield:** Mature cataract is the optimal stage for cataract surgery. The distinction between mature and intumescent is that intumescent cataracts show lens swelling with shallow anterior chamber, whereas mature cataracts have normal anterior chamber depth. **Mnemonic:** **MANIC** — Mature = Absent red reflex, Normal AC depth, Intumescent = swollen, Cortical opacity, Immature = red reflex present. 
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