What are the key features of hypermature cataracts?

What are the key features of hypermature cataracts?

• A. Capsular wrinkling and protein aggregates (correct)
• B. Tapetal reflection
• C. Increased lens elasticity
• D. Pigment deposition

Answer: (A)

Hypermature cataracts show advanced lens degeneration where the cortical material liquefies while the nucleus remains and may sink, with the capsule undergoing contraction. This combination produces two classic clues: the capsule becomes wrinkled and the lens proteins denature and precipitate into aggregates. The wrinkling comes from the capsule shrinking as the surrounding cortex liquefies and drains, while the protein aggregates reflect denatured crystallins clumping together within the lens. These features together are the hallmark of the hypermature stage. Tapetal reflection isn’t a human ocular finding and isn’t linked to this cataract stage; increased lens elasticity isn’t expected as the lens becomes more brittle with advanced cataract; pigment deposition isn’t a defining feature of hypermature cataracts.

Hypermature cataracts show advanced lens degeneration where the cortical material liquefies while the nucleus remains and may sink, with the capsule undergoing contraction. This combination produces two classic clues: the capsule becomes wrinkled and the lens proteins denature and precipitate into aggregates. The wrinkling comes from the capsule shrinking as the surrounding cortex liquefies and drains, while the protein aggregates reflect denatured crystallins clumping together within the lens. These features together are the hallmark of the hypermature stage. Tapetal reflection isn’t a human ocular finding and isn’t linked to this cataract stage; increased lens elasticity isn’t expected as the lens becomes more brittle with advanced cataract; pigment deposition isn’t a defining feature of hypermature cataracts.