Kerala Journal of Ophthalmology

: 2020  |  Volume : 32  |  Issue : 1  |  Page : 8--9

Cartwheel-like appearance of a variant of congenital zonular (lamellar) cataract

Bharat Gurnani, Kirandeep Kaur, Arthi Mohankumar, Veena Kannumsamy, Prasanth Gireesh 
 Department of Cataract and Iol and Pediatric and Squint Services, Aravind Eye Hospital, Pondicherry, India

Correspondence Address:
Dr. Bharat Gurnani
Cornea Fellow, Aravind Eye Hospital and Post Graduate Institute of Ophthalmology, Pondicherry - 605 007

How to cite this article:
Gurnani B, Kaur K, Mohankumar A, Kannumsamy V, Gireesh P. Cartwheel-like appearance of a variant of congenital zonular (lamellar) cataract.Kerala J Ophthalmol 2020;32:8-9

How to cite this URL:
Gurnani B, Kaur K, Mohankumar A, Kannumsamy V, Gireesh P. Cartwheel-like appearance of a variant of congenital zonular (lamellar) cataract. Kerala J Ophthalmol [serial online] 2020 [cited 2020 Aug 8 ];32:8-9
Available from:

Full Text

 Case Report

A 41-year-old male presented with complaints of defective vision in the right eye for the past 6 months. Anterior segment examination revealed developmental lamellar (spokes of a wheel) cataract [1] OD [Figure 1] and [Figure 2] involving the nucleus:{Figure 1}{Figure 2}

Clinical sign – Cartwheel-like appearance of a variant of congenital zonular (lamellar) cataractSeen in – Rickets (first described in rickets) and tetanyDescribed by – Davidson and Horner, 1865Why it occurs – Lamellar cataract is the most common type of developmental cataract producing visual impairment. Its effect on vision depends primarily on the density of its components, especially the nucleus.[2] The pathognomonic clinical appearance occurs due to concentric sharply demarcated lamellae of opacities around a central clear nuclear core with linear opacities such as spokes of a wheel (called riders) running toward the equator. Usually, inherited in autosomal dominant pattern, it may be caused by mutations in the heat-shock transcription factor-4 gene located at 16q21-q22.[3] Syndromic associations are rareWhat else to examine – Look for nystagmus which is commonly associated with zonular cataract.

Answer to the spot diagnosis of previous issue:

Clinical condition is congenital lamellar ichthyosis (collodion baby). Main types of ichthyosis are ichthyosis vulgaris, lamellar ichthyosis, and epidermolytic hyperkeratosis. Ectropion in lamellar ichthyosis may respond to conservative management

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.


1Tijani M, Albaroudi N, El Bouaychi A, Laghmari M, Boutimzine N, Cherkaoui O. Congenital lamellar cataract. J Fr Ophtalmol 2017;40:527-8.
2Gerth-Kahlert C, Michels R, Funk J, Gautschy U. Congenital lamellar cataract. JAMA Ophthalmol 2014;132:1122.
3Bu L, Jin Y, Shi Y, Chu R, Ban A, Eiberg H, et al. Mutant DNA-binding domain of HSF4 is associated with autosomal dominant lamellar and Marner cataract. Nat Genet 2002;31:276-8.