Learn vocabulary, terms, and more with flashcards, games, and other study tools. The 2024 edition of ICD-10-CM H05. 1. 1. 4: Posterior subcapsular cataracts Sign in. Seen on slit lamp examination 22. Design: Retrospective cohort study. 01/01/2021. Subscribe to Codify by AAPC and get the code details in a flash. injury (trauma) of eye and orbit ( S05. The nerve appearances were consistent. The deep learning model identifies the type. 0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular. Centreville Bank CD Account Promotion (RI) Town & Country Federal Credit Union CD Promotion: 3. ICD-10 code H25. 029 to ICD-9-CM. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L38926, Cataract Extraction (including Complex Cataract Surgery). Known as ‘cortical spoking’ cataracts, these opacities vary greatly from nuclear cataracts for their appearance of a bicycle wheel. 50% APY 30-Month CD Rate Special (AZ) More. 04 - other international versions of ICD-10 H25. what type of shift does a cortical spoking cataract cause? hyperopic. These changes may be extensive but may not affect. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. “Water clefts” appear to begin as splits in suture lines, with remnants of. There are three primary types of cataracts: nuclear sclerotic, cortical, and posterior subcapsular they also have unique symptoms which are discussed below. Optic nerve head,. #1. Cortical cataract demonstrating white cortical spoking. 67mm 2 14yo African American Female VA: cc through CL Distance. Main Outcome Measures. How would you proceed? Which IOLs would you consider? —Case prepared by Audrey R. Posterior segment exam shows no abnormality and the fundus pigmentation is normal OU. Pediatric Ophthalmology 29 years experience. Central serous (chorio) retinopathy. Posterior subcapsular cataract (PSC) – Opacity in the posterior capsule of the lens, often seen in younger individuals, steroid users, and diabetics. Subscribe to Codify by AAPC and get the code details in a flash. In the subgroup of patients aged under 50. B, Typical cortical spokes. Cortical Spoking E. Ophthalmology 27 years experience. 4: Posterior subcapsular cataracts Sign in. ICD-10 Diagnosis Codes: H25. These begin with the formation of small vacuoles and clefts. terior subcapsular cataract, cortical spoking), with each rated on a scale from clear to 4+. An examination of the anterior segment of the right eye reveals an anterior subcapsular cataract with cortical spoking. The CD ratio was 0. 1. Cortical Cataracts. The lens characteristics in both eyes showed 2+ to 3 nuclear sclerosis and cortical spoking extending closely into the visual axis. When we see this gap it is often associated with zonular laxity which allows the cataract to fall towards the vitreous cavity. 다른 모든 것이 동일할 때 일반적으로. intermittent exotropia. This is a normal part of the aging process called nuclear sclerosis. Inferior nasal cortical spoking with early nuclear sclerosis. The white lines in B represent a transparent region that is superficial to the opaque region. Cyclophotocoagulation. ; atrophic hole inf/nasal OS: lattice, pigmented superior, inferior, temporal Vitreous: syneresis, PVD OU OD: 30. 49 Slow-motion careful tangential stripping of the cortex from anterior and posterior capsules under low-flow conditions in combination with gentle centripetal. 013 is a valid billable ICD-10 diagnosis code for Cortical age-related cataract, bilateral . Michael Gabor answered. Smartphone applications for detecting cataract rely on lens color and texture features, but as noted before, the color-based methods they use aren’t universally. Posterior Subcapsular Cataracts. Study with Quizlet and memorize flashcards containing terms like nuclear sclerotic cataract, Blue Scleras, Episcleritis Connective tissue disease Wind, dust, chemicals, sun and more. This peripheral part of. RA Factor - neg. U. D. Cataracts that start growing at the outer edge of the lens are called cortical cataracts. Six DSEK eyes (10%) developed anterior cortical spoking. ICD-10-CM Code for Cortical age-related cataract, unspecified eye H25. Gray matter (neuronal cell bodies) of the brain forms a rim over the cerebral hemispheres, forming the cerebral cortex. and a mixed cataract with 3+ nuclear sclerosis, cortical spoking, and posterior subcapsular opacities in each eye • Tear break-up time was 5 seconds OU • Tear osmolarity was modestly elevated and asymmetric at 302 mOsm/L OD and 313 mOsm/L OS The Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire (availableLens: cortical opacities, 1+cortical spoking OU 2+PSC Disc: staphyloma OU, oblique insertion C/D: 0. 0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular. X (T) exotropia. 80% APY 12-Month, 5. Because the patient’s cortical cataracts affect both eyes, you’ll select H26. Related: ODs: Redefine your role in glaucoma collaborative care. Plus resources to find the right surgeon and a step-by-step guide to everything you need to know about surgery if you choose to have it. Read More. 4/24/2018 12 Complete/White Systemic DiseaseOn exam, her cataracts were graded as 2+ NS (nuclear sclerotic) and 2+ cortical spoking OU. protein aggregation b. Ophthalmology 11 years experience. 011 may differ. 3. 041--Posterior subcapsular polar senile cataract, right eye H25. Completely opacified cortex causing the lens to appear white; no red. Both lenses show 2+ cortical spoking and 1+ nuclear sclerosis, consistent with 20/40. Article Text. The following code (s) above H25. (C) A higher magnification of an Arvcf−/− lens with a disruption at the anterior pole that occurs along a suture line. The stereo coaxial illumination extends. The following code (s) above H25. They may be peripheral only and therefore cause no symptoms. It is found in the 2023 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2022 - Sep 30, 2023 . These lens changes were symmetric between the eyes. CME MONOGRAPH Ophthalmology Insights ™ Case Studies in Dry Eye Disease, Glaucoma, and Diabetic Macular . People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. Subscribe to Codify by AAPC and get the code details in a flash. Seen on slit lamp examination. Nuclear sclerosis is common in older adults as part of the aging process of the eye and can lead. do_shortcode ( ‘ ‘ ) . YAG. in a. 03 : H00-H59. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. 011 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 013 - other international versions of ICD-10 H25. 0 using the lens opacities classification system LOCS II before and after pars plana. 1 In the UK, childhood cataract affects 2. Wedge-shaped (cuneiform) or spoke-like (wheel) peripheral changes are seen. 4 Cataracts were evaluated at the time of the preoperative visit closest to the date of surgery and on all subsequent postoperative visits. Posterior subcapsular cataract (PSC) – Opacity in the posterior capsule of the lens, often seen in younger individuals, steroid users, and diabetics. The risk factors include –. 35. Mature cataract . Request a Demo 14 Day Free Trial Buy Now. Subscribe to Codify by AAPC and get the code details in a flash. Mature cataract with white, liquefied cortex. 1. It can be highly difficult to view the red reflex in patients with small pupils, darkly pigmented eyes, dense anterior cortical spoking, and brunescent cataracts. With the Lumera, a clearer view of the anterior capsule and red reflex enables me to complete the capsulorhexis without difficulty (Figure 3). GVF OD with temporal scotoma. ICD-10 code H25. 3 OS Periphery: OD: lattice, pigmented sup. IOP measured 18 mm Hg OU. minimal degree of cortical opacification and/or minispoke formation. This is the American ICD-10-CM version of H25. Completely opacified cortex causing the lens to appear white; no red reflex visible from fundus. There are three types of cataract according to the WHO (nuclear sclerotic, cortical spoking and posterior subcapsular) that are defined and graded by examining the opacities. Her crystalline lenses were characterized by mild/moderate nuclear sclerosis and cortical spoking to a degree consistent with her visual acuities. The code H25. The arrowheads demonstrate regions of cortical spoking. Fifteen months after the addition of quetiapine, an optometry examination revealed lenticular changes in the left eye and grade I cortical spoking in the interior aspect of the lens . intermittent exotropia. 1. The second type is called nuclear sclerosis and is characterized by a hardening and yellowing of the lens. Given that the likely cause of her decreased objective visual acuity was her. 50 & 4. 012 for Cortical age-related cataract, left eye is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa . This is a normal part of the aging process called nuclear sclerosis. 619 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 019 became effective on October 1, 2023. Cataract/Anterior Segment. ” The clinician did not feel her visual complaints were related to the corneal findings revealed on exam. Talley Rostov, MD CASE PRESENTATION. Chronic alcoholism. The center of your lens turns yellow and gets harder as you age. 50%. Upon evaluation of the lenses, the patient had grade two nuclear sclerosis in both eyes, along with cortical spoking greater in the right eye than in the left. 013 may differ. Dilated fundus examination revealed 1+ nuclear sclerosis, 1+ anterior cortical spoking, and 2+ posterior capsular cataracts OU. There was no diabetic retinopathy OU. We have assembled a list of common abbreviations that you are bound to encounter. Study ocular lens flashcards from Tiff Moon's class online, or in Brainscape's iPhone or Android app. Discuss techniques to evaluate cataracts and effects on vision. U. e. Result from the ionic lens composition lens cortex and the eventual change in the hydration of the. Cortical versus Subcortical Strokes. 3 OS. 4 OPHTH 15 AFHSB Surveillance Case Definitions FINAL August 2016 - H26. There are three primary types of cataracts: nuclear sclerotic, cortical, and posterior subcapsular they also have unique symptoms which are discussed below. The median age at diagnosis is 46 years. Data collected on these patients included age, ethnicity, sex, preoperative best-corrected visual acuity, cataract grade (nuclear sclerosis vs cortical spoking vs posterior subcapsular), lens thickness, first versus second eye, right versus left eye, birth month and insurance status. Methods: The visual results and. and the constancy of symptoms support the concept that the pathology is cortical. Created for people with ongoing healthcare needs but benefits everyone. PSCs may also be seen with steroid use and diabetes, which can confound assessment of cataract cause . 3 OD OS ERM Central atrophy with RPE hyperplasia. Cortical cataracts develop when the more peripheral lens fibers. Study with Quizlet and memorize flashcards terms like About, 5 Flurouracil, Astigmatism and more. Participants were included if they had normal age-related lens changes. The anterior vitreous of the right eye showed densely packed asteroid hyalosis (Fig. 03 - other international versions of ICD-10 H25. -PROCEDURE: Extracapsular cataract extraction (ECCE) with a posterior chamber intraocular lens implant, right eye, 66984. What is a cortical spoking cataract? Moderate cortical changes. Posterior cortical spoking OS Timolol BID OU Brimonidine BID OU Blot hemes inferior-temp Unremarkable 0. H25. Cortical senile cataract. Nuclear sclerotic, cortical (‘spoking’), and subcapsular cataracts will comprise the vast majority of those seen in clinic. 1. Author(s): Michelson, Georg, Prof. 011Cortical age-related cataract, right eye. LaparoscopicIt can be highly difficult to view the red reflex in patients with small pupils, darkly pigmented eyes, dense anterior cortical spoking, and brunescent cataracts. Age-related cataract (H25) Cortical age-related cataract (H25. Nuclear sclerosis is a condition in which the nucleus, or central part of the lens of the eye, hardens or gets cloudy. 67mm 2 14yo African American Female VA: cc through CL Distance. Thank. It's one of the most common types of cataracts. A loss of vision (or an increased loss in vision) Vision that only occurs in one of your eyes (this is technically known as monocular diplopia) Glare from the sun or from. Increased sun exposure to eyes without UV protection. 04 may differ. The white lines in B represent a transparent region that is superficial to the opaque region. The conventional Convolution Neural Network (CNN), in conjunction with support vector machines (SVM), classifies nuclear, cortical spoking, and capsular cataract eyes. Refer to NCCI and OPPS requirements prior to billing Medicare. Change in perception of colors. Study with Quizlet and memorize flashcards containing terms like Cerulean, Cerulean, Sutural and more. Senile cataract is a yellowing of the entire crystalline lens. Then we present the data regarding the risk of each type of radiation effect to the fluoroscopy. 01 contain annotation back-references that may be applicable to H25. 0 mm incisions placed 2. The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. Radiation-induced cataracts are predominantly PSCs, although cortical and mixed-type cataracts have been shown . 40 round with healthy rim tissue OD, OS, without neovascularization of the disc (NVD). Learn how we can help. C, Horizontal optical coherence tomography (OCT) showing retinoschisis extending into the optic nerve. This is the American ICD-10-CM version of H25. 011 became effective on October 1, 2023. Cataract: Cortical cataract is a change in the peripheral portion of the crystalline lens which extends centrally. View Homework Help - HW - C6 - Review exercise + Coding Challenge. Her BSCVA was 20/60 OD and 20/20 OS. D. expected (x-axis) P-values from genome-wide association tests for the bivariate outcome of cortical cataract and temporal horn volume. reveals an anterior subcapsular cataract with cortical spoking. Ciliary body. While there are no scientifically approved medications designed to cure cataracts, there are several treatment options available, including: Prescription Glasses: Since cortical cataracts can result in decreased visual acuity, glasses may be prescribed to make up for the vision loss. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. Connect with a U. Mature cataract. In this case, there is no serious zonular laxity. Discover the truth about whether you really need cataract surgery. The 2024 edition of ICD-10-CM H25. Disorders of lens. -Nuclear Sclerotic: Near-sized, slow course -Cortical spoking: doesn’t significantly affect vision -Posterior Subcapsular: leads to a “glare”and glare in bright-light (more of a common complaint) Divided into mature and immature cataracts MUST KNOW CONCEPTS -Mature: obstructs the redlight reflex when you do a fundus exam and has. Thus white for bone or stone. you can tell it's an anterior cortical cataract because the iris is still pretty clear and in focus. Glare and / or difficulty driving at night. Cataract: In the context of cataract formation, cortical spoking refers to the peripheral and superficial (cortex) clouding of the lens in the pattern of spokes. adj. Phacoemulsification surgery has proven itself effective with its positive correlation to CDE scores. A type 1 excludes note indicates that the code excluded should never be used at the same time as H26. 0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular. SLE: Anterior cortical spoking cataract OS; Optic nerves were normal OU; DFE: Atrophic holes OD, macula striae OS; Palpebral fissure: 10mm OD and OS; Hertel: 92mm base; 17mm OD and 18mm OS; Figure 1: GVF GVF OS with supero-nasal and infero-nasal constriction of all isopters. Study with Quizlet and memorize flashcards containing terms like old ppl do they gave relatively good or bad high contrast VA vs low contrast VA, when u hit 40 do u need an add?, how do peoples hyperopia change with age and more. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. 15 is a billable medical code that can be used to indicate a diagnosis on a reimbursement claim, however, 366. 1c [1]. Cortical cataracts develop in the lens’s cortex, encircling the central nucleus. H25. Practice: Cataract Grading. This is the most common form of cataract. The optometrist diagnoses the. Slit lamp examination showed mild NS, mild cortical spoking OU on the lens, with no other significant findings noted. 1). No matter the frequency of eyedrop advertisements for cataract removal, surgery remains the only sure way to restore vision effectively. 3 OS Periphery: OD: lattice, pigmented sup. Attempts were made to contact referring ophthalmologists in patients who were lost to follow. 61 - other international versions of ICD-10 H47. Image License and Citation Guidelines. It begins at the nucleus of the eye (the central zone). His cataracts were estimated to account for one, and perhaps two, lines of visual acuity decrease. Cortical - Visualized as "aggregate" and quantified on the basis of the percentage of intrapupillary space obscured PSC - Graded on the basis of percentage of the area of the posterior. Cataract: Cortical cataract is a change in the peripheral portion of the crystalline lens which extends centrally. Color vision D. The change from nuclear sclerosis or cortical spoking to frank cataract formation is gradual. There was no evidence of pseudoexfoliation. 013 for Cortical age-related cataract, bilateral is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa . Official Long Descriptor. Cortical Spoking or cortical cataracts: Anterior Cortical Cataract (ACC) Posterior Cortical Cataract (PCC) Posterior Subcapsular Cataract (PSC) Nuclear Sclerotic Cataract. Main outcome measures: The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. They initially manifest as white wedge-like opacities or streaks on the lens’s outer edge. The 2024 edition of ICD-10-CM H25. Fig. Eyes were graded on a scale of 0 to 4. Cataract still remains the world’s leading cause of blindness and visual impairment in the elderly population, despite the decreasing number of people affected. Morgagnian cataract . change in the cortex of the posterior lens of the eye. 3: Cortical Spoking Cataracts. 35 is applicable to adult patients aged 15 - 124 years inclusive. It may eventually lead to a cortical cataractvisible changes; Stage 1, cortical spoking appears; Stage 2, water vacuoles appear; Stage 3, cataract ring; Stage 4, frank cataract. To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking cataracts in nondiabetic patients <50 years of age after a pars plana vitrectomy. Because ofthe patient's cataract-related complaints, phacoemulsification was performed first on the left eye and then on the right. METHODS —Eight women and 12 men, mean age 73 years, were included in this study, which was carried out from 1 January 1994 to 30 November 1996. The number of SNPs (188,629). Senile cataract is a yellowing of the entire. 2 with collaterals 0. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). Previous eye surgery is correlated with an increase in cortical cataracts. Study with Quizlet and memorize flashcards containing terms like MP, PCC, PCO and more. 6: Artificial lenses Sign in. Lens: cortical opacities, 1+cortical spoking OU 2+PSC Disc: staphyloma OU, oblique insertion C/D: 0. OBJECTIVE. Blurry lines that affect vision. and the constancy of symptoms support the concept that the pathology is cortical. n. a cortical spoking cataract is often first seen where due to sun exposure? inferonasal. yttrium-aluminum-garnet laser. Created for people with ongoing healthcare needs but benefits everyone. Business, Economics, and Finance. The three main types are: Posterior subcapsular. Please refer to the LCD for reasonable and necessary requirements. 013 became effective on October 1, 2023. View Full Image. 013 is applicable to adult patients aged 15 through 124 years. Posterior segment of the left eye shows a dense vitreous hemorrhage with a positive red reflex. [ 1] Although it mainly occurs in adults, children can be affected too. you can tell it's an anterior cortical cataract because the iris is still pretty clear and in focus. true. They were characterised by the onset of a lenticular. H25. 65/0. ANA is neg. Cigarette smoking. Cancel anytime. Note the yellowing of the nucleus (nuclear sclerosis) and cortical spoking (cortical cataract) in this combined cataract. Then we present the data regarding the risk of each type of radiation effect to the fluoroscopy. Chorioretinal scar. Start studying Ophtho 5 - Chronic Vision Loss. Yes:. Create flashcards for FREE and quiz yourself with an interactive flipper. The membranes of mature lens fibre cells are disrupted, resulting in protein oxidation and precipitation of cellular material. Create flashcards for FREE and quiz yourself with an interactive flipper. The optic nerves were 0. ; however, these changes were mild and inconsistent with his reduced vision. Researchers are studying the biological mechanisms that cause cataracts to develop. Senile cataract is a yellowing of the entire. Slit-lamp examination demonstrated bilateral combined cataracts of 3+ nuclear sclerosis, 1+ cortical spoking, and 1+ posterior subcapsular opacity. Soon enough you’ll be the one interpreting for the poor student on a medicine service! In the meantime, we hope you’llOcular examination revealed healthy ocular surface and cornea, a 1+ nuclear sclerotic cataract with 2+ cortical spoking, and a healthy retina. The principal opportunities for intra-operative lens trauma occur during removal of dysfunctional recipient endothelium and Descemet. 5: Posterior capsular opacifications Sign in. 419A is grouped within Diagnostic Related Group(s) (MS-DRG v 41. As they progress, these streaks gradually move toward the center, taking on an appearance similar to spokes in a bicycle wheel. Vision can be affected in various ways, depending on exact location and prominence of these spokes. If it gets severe enough, it becomes a nuclear cataract. A 6. 0 using the lens opacities classification system LOCS II before and after pars plana. A type 1 excludes note is a pure excludes. Diabetes. OBJECTIVES—To analyse the clinical features induced by lenticular infarction found in 20 patients, and to analyse the radiological and clinical correlations. 2 OD, 0. 3 OS Periphery: OD: lattice, pigmented sup. 11 Follow-up of at least 1 year was attempted, but some patients were discharged from care because of transportation difficulties or were lost to follow-up before 1 year. Le, MA, Susan Hutfless, SM, PhD, Tianjing Li, MD, MHS, PhD, Neil M. To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking. I measured contrast sensitivity and glare in 51 cataract patients who had Snellen visual acuities of 20/60 or better. Soon enough you’ll be the one interpreting for the poor student on a medicine service! In the meantime, we hope you’llStudy with Quizlet and memorize flashcards containing terms like pseudophakia, aphakia, subluxation/luxation and more. X (T) exotropia. 1. Allografts for spinal surgery include machined cancellous blocks, cortical dowels, cortical rings, PLIF and ALIF grafts, cortical and cancellous spacers of various sizes. . A variety of cannula are available for this maneuver, though a surgeon should default to the equipment with. Please refer to the LCD for reasonable and necessary requirements. The results of eye examinations at baseline, 6 months, and 12 months were unremarkable. cortical spoking. ICD-10 code H25. Low-level vision features are used to characterize the photometric appearances and geometric structures of cortical and PSC cataracts in retroillumination images. GameStop Moderna Pfizer Johnson & Johnson AstraZeneca Walgreens Best Buy Novavax SpaceX TeslaType of cataract was also recorded (nuclear sclerosis, cortical spoking, posterior subcapsular). Created for people with ongoing healthcare needs. Main Outcome Measures: The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from care, lost to follow-up, or last visit before cataract surgery. 35K subscribers in the optometry community. Start studying OTM 4 - Lecture 1 Lens and Vitreous. Open source ophthalmology education for students, residents, fellows, healthcare workers, and clinicians. 3 OS. Background: Differentiation between acute cortical and subcortical ischemic stroke may be problematic when cortical stroke presents without obvious cortical deficits such as aphasia, neglect or hemianopia. We determined that this was a classic case. For example, if you observe cortical spoking and nuclear opacification, your patient likely has both cortical and nuclear sclerotic. BILLABLE Adult Only | ICD-10 from 2011 - 2016. Asymmetrically located, radial, linear opacities and punctate dots. 16. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. Early cortical cataract development as viewed at the slit lamp using retroillumination. What are the symptoms of cortical spoking cataract? The symptoms of cortical spoking cataract can include blurred or hazy vision, difficulty seeing in. 3 Cortical. H25. 013 - other international versions of ICD-10 H25. The NSC, PSC, and cortical spoking scores were recorded preoperatively and 1, 3, 6, 9, and 12 months after surgery until discharged from. 013) H25. You may become a victim of cortical cataracts, even if you are young or middle-aged. All of the above are likely to be found F. It means "not coded here". Diagnosis 2: Nuclear Cataracts. A “Morgagnian“ cataract, is an extremely difficult case because the center is liquefied, increasing risk of dropping the nucleus into the vitreous during surgery. Fifteen months after the addition of quetiapine, an optometry examination revealed lenticular changes in the left eye and grade I cortical spoking in the interior aspect of the lens . Kataria and Thompson performed a clinical records review to measure the development and rate of progression of nuclear sclerotic (NSC), posterior subcapsular (PSC), and cortical. Cortical Spoking: Because of swelling in the cortex, spoke-like cloudiness develops on the outer edge of the lens. Causes of Cortical Cataracts.