These changes may be extensive but may not affect. ICD-10-CM Coding Rules. Study iris and lens flashcards. Bressler, MD, James Heyward, BA, Ava K. 0 using the lens opacities classification system LOCS II before and after pars plana. Morgagnian cataract . Dilated fundus examination revealed 1+ nuclear sclerosis, 1+ anterior cortical spoking, and 2+ posterior capsular cataracts OU. Cataracts almost invariably accompany old age. you can tell it's an anterior cortical cataract because the iris is still pretty clear and in focus. 013 may differ. 61 : H00-H59. Posterior cortical spoking OS Timolol BID OU Brimonidine BID OU Blot hemes inferior-temp Unremarkable 0. Morgagnian 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. The deep learning model identifies the type. Created for people with ongoing healthcare needs but benefits everyone. S. This was the slit lamp appearance of the right eye: A prominent conjunctival vessel was visible inferonasally, and the lens opacity was more prominent in that quadrant. 61 became effective on October 1, 2023. Cortical Spoking: Posterior Subcapsular: NS tr or 1+: Nucleus clearer than anterior / posterior sections NS 2+: Nucleus equal to the anterior posterior sections (same opacity level throughout) NS 3+/4+: Nucleus denser than anterior / posterior sections Dense white/brunescent: Cataract completely opaque / brown: CS 1+: ⅛ to ¼ of total CS 2. Read More. Methods: In this prospective, observational, cross-sectional, non. Lens: cortical opacities, 1+cortical spoking OU 2+PSC Disc: staphyloma OU, oblique insertion C/D: 0. 67mm 2 14yo African American Female VA: cc through CL Distance. P0 Clear posterior capsule. The arrowheads demonstrate regions of cortical spoking. 2 OD, 0. 042--Posterior subcapsular polar senile. It is found in the 2022 version of the ICD-10 Clinical Modification (CM) and can be used in all HIPAA-covered transactions from Oct 01, 2021 - Sep 30, 2022 . Her crystalline lenses were characterized by mild/moderate nuclear sclerosis and cortical spoking to a degree consistent with her visual acuities. To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking. The prediction result gives an opacity. Her BSCVA was 20/60 OD and 20/20 OS. 50% APY 30-Month CD Rate Special (AZ) More. Given that the likely cause of her decreased objective visual acuity was her. Cortical Cataracts. Cataract/Anterior Segment. Cigarette smoking. Dr. This article contains coding and other guidelines that complement the local coverage determination (LCD) for Cataract Extraction. Cortical spoking cataract (CS) - Swelling of the cortex causing spoke/wedge-like peripheral cloudiness. The authors found that there was a small, though. T/F cortical spoking and PSC can be best graded with retroillumination of the LENS. Start studying Ophtho 5 - Chronic Vision Loss. The patient was never told of any retinal problem prior, but examination reveals an epiretinal membrane (ERM) in the right eye. Low-level vision features are used to characterize the photometric appearances and geometric structures of cortical and PSC cataracts in retroillumination images. Posterior subcapsular cataracts are also more common in younger age groups and are frequently associated with diabetes or. Please refer to the LCD for reasonable and necessary requirements. Nuclear cataracts are graded according to their color and opacification using slit lamp examination. Image License and Citation Guidelines. CII. H25. 2 with collaterals 0. The 2024 edition of ICD-10-CM H25. Pbm in brain not eye: The term cortical vision impairment implys that there is a problem with the brain cortex (outer cell layer) that interprets the imput of. 011Cortical age-related cataract, right eye. The hardening occurs gradually. The proposed method was successful in accurately classifying the two classes. 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. Cataracts symptoms floaters. Read More. One of the rods or braces connecting the hub and. (C) A higher magnification of an Arvcf−/− lens with a disruption at the. Often, a shift in nearsightedness is noted, ranging from one to six diopters. 61 may differ. yttrium-aluminum-garnet laser. A, Fundus autofluorescence photograph of the right eye showing slight radial hypofluorescence around the fovea corresponding to cortical spoking. 619 became effective on October 1, 2023. He had 2-3+ nuclear sclerosis and 2+ cortical spoking in both eyes. It can be treated with surgery to replace your lens with an artificial one. The second type is called nuclear sclerosis and is characterized by a hardening and yellowing of the lens. However, this is only a short term solution as the cortical. 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 . The patient was never told of any retinal problem prior, but examination reveals an epiretinal membrane (ERM) in the right eye. Cortical cataract demonstrating white cortical spoking. 50 & 4. OBJECTIVE. white and quiet. 40 round with healthy rim tissue OD, OS, without neovascularization of the disc (NVD). View Full Image. 1. The revised LCD and related billing and coding article provide coverage for cataract surgery, including complex surgery. 1. Corneal topography or tomography. 013 became effective on October 1, 2023. H25. 01) H25. According to the WHO, there are three main types of cataracts: 1) nuclear sclerotic cataract (NS), 2) cortical spoking cataract (CS), and 3) posterior subcapsular cataract (PSC) which are shown in. This is a normal part of the aging process called nuclear sclerosis. The principal opportunities for intra-operative lens trauma occur during removal of dysfunctional recipient endothelium and Descemet. Le, MA, Susan Hutfless, SM, PhD, Tianjing Li, MD, MHS, PhD, Neil M. Methods: Records of consecutive patients with acute. There are three primary categories of cataracts, each depending on where opacities form in the lens: nuclear sclerotic cataract — this is the most prevalent age-related form; cortical spoking cataract — when an opaque patch forms on the cortical layer that surrounds an apple core; and hypermature cataract — when all protein in the lens. 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. Cortical Cataract Grading. The proposed method was successful in accurately classifying the two classes with an accuracy of 85. ICD-10 code H25. Cortical opacities were twice as prevalent as Achilles tendon thickening (16. white and quiet. 013 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 04 : H00-H59. S. Increased sun exposure to eyes without UV protection. Causes and Symptoms . The left eye showed an old branch vein occlusion in the superotemporal region, with extensive retinal venous collaterals. 1. Holds the natural lens in place behind the pupil, enables accommodation of. Main Outcome Measures. If the opacity is in the central portion of the lens (shown in Fig. Now with ICD-10 his office schedules with ICD-10 H25. Short description: Infantile and juv cortical/lamellar/zonular cataract, r eye; The 2024 edition of ICD-10-CM H26. D. The lack of monocular or homonymous visual field defect makes. Read More. 3 Cortical. 후낭하 백내장(PSC) – 수정체 후낭의 혼탁으로 젊은 사람, 스테로이드 사용자 및 당뇨병 환자에게 자주 나타납니다. There is actually a wide variety of symptoms caused by cataracts: Blurry vision. Symptoms of cortical. Participants were included if they had normal age-related lens changes. Mature cataract . The onset of the posterior subcapsular cataracts in the previous six months contributed greatly to her decreased. Funduscopically, diffuse, dark brown. Full-Field ERG E. cortical: [adjective] of, relating to, or consisting of cortex. a cortical spoking cataract is often first seen where due to sun exposure? inferonasal. Cortical spoking Clinically significant diabetic macular edema Central serous (chorio) retinopathy: DCR DES DME DR DSAEK: Dacryocystorhinostomy Dry eye syndrome Diabetic macular edema Diabetic retinopathy Descemet stripping automated endothelial keratoplasty: E ECCE EKC EL ELP ERM ET E(T) EsophoriaCortical spoking cataract. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. Image License and Citation Guidelines. Subscribe to Codify by AAPC and get the code details in a flash. ICD-10-CM Code for Cortical age-related cataract, unspecified eye H25. grade ONLY THE NUCLEUS!-Optical Separation - dark line showing border between nucleus and cortex (not grade 1 until this is seen)-Brunescence - brown/orange nucleus; reserved for. Cortical spoking is easily visualized using retro-illumination on the slit-lamp; CLASSIFICATION. Connect with a U. ICD-10 code H25. Subscribe to Codify by AAPC and get the code details in a flash. 2: Nuclear sclerotic cataracts. It is more common in people with diabetes and hypertension. 75/0. 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. Dean Bonsall answered. The left eye was otherwise unremarkable. The revised LCD and related billing and coding article provide coverage for cataract surgery, including complex surgery. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. In this study, all younger subjects were graded as clear and all older subjects were graded as +1 nuclear sclerosis or better. Official Long Descriptor. The phakic IOL is well positioned but may exhibit slight temporal displacement. Known as ‘cortical spoking’ cataracts, these opacities vary greatly from nuclear cataracts for their appearance of a bicycle wheel. Comments. white and quiet. OBJECTIVES—To analyse the clinical features induced by lenticular infarction found in 20 patients, and to analyse the radiological and clinical correlations. Purpose : To measure the rate of cataract development and progression of nuclear sclerotic (NSC), posterior subcapsular (PSC) and cortical spoking (CS) cataracts in non-diabetic patients younger than 50 years of age following a pars plana vitrectomy. The white lines in B represent a transparent region that is superficial to the opaque region. Subjects: Twenty-six eyes of 26 patients><50 years of age that had. Posterior Subcapsular Cataracts. Pediatric Ophthalmology 29 years experience. Advancing age. Eyes were graded on a scale of 0 to 4. The lack of monocular or homonymous visual field defect makes. 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. yttrium-aluminum-garnet laser. “The patient will also be complaining of significant glare and haloes around lights, especially at night. Poor ability to see contrast, such as in a dark or dimly lit environment. Which of the following is not handy when diagnosing RP? A. The risk factors include –. 35 vertical and horizontal OU. We have assembled a list of common abbreviations that you are bound to encounter. VF B. The three main types are: Posterior subcapsular. 03 contain annotation back-references that may be applicable to H25. 013 for Cortical age-related cataract, bilateral is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa . Adrenocortical carcinoma (ACC) is a rare tumor with an annual incidence of 2 cases per 1 million population. Scenario: A 72-year-old patient presents to the practice with blurred vision and slight yellow tinting to the left eye. There are three different kinds of cataracts: nuclear sclerosis, cortical spoking and posterior. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. Dr. "Cortical" refers to white opacities, or cloudy areas, that develop in the lens cortex, which is the peripheral (outside) edge of the lens. When using code H25. CI. SD: Standard deviation, NS: Nuclear sclerotic, CS: Cortical spoking, PSC: Posterior subcapsular cataract Figure 1: Scatter plot of multiple regression analysis of surgical time during theThrough dilated pupils his crystalline lenses were characterized by early nuclear sclerosis bilaterally, as well as cortical spoking off the visual axis. Her cornea also demonstrated a polygonal pattern of opacities in the posterior stroma with clear intervening spaces, resembling a “crocodile. Quetiapine was tapered off over 9 days, and an eye examination conducted. Dilated fundus examination revealed moderate nuclear sclerosis and minimal anterior cortical spoking of both crystalline lenses. Wedge-shaped (cuneiform) or spoke-like (wheel) peripheral changes are seen. Fig. Study with Quizlet and memorize flashcards containing terms like Types of cataracts, nuclear cataract, cortical cataract and more. 65/0. No phacodonesis is evident. Nuclear sclerosis is common in older adults as part of the aging process of the eye and can lead to. 013 is a valid billable ICD-10 diagnosis code for Cortical age-related cataract, bilateral . Because ofthe patient's cataract-related complaints, phacoemulsification was performed first on the left eye and then on the right. For example, if you observe cortical spoking and nuclear opacification, your patient likely has both cortical and nuclear sclerotic. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. This is the American ICD-10-CM version of H47. It has little or no effect on vision, but the blue-gray appearance of the lens often prompts a misdiagnosis of cataract. Simply stated, a cataract is present when the physiologi. Pseudoexfoliation syndrome (also called PXF, PXE or PEF) involves these parts of the eye: Aqueous humor. H05. Thompson MD* ABSTRACT Purpose: To evaluate the visual results of vitrectomy for epiretinal membrane in eyes with a preoperative visual acuity of 20/50 or better. IOP measured 18 mm Hg OU. See a neurologist for guidance. Cortical Spoking or cortical cataracts: Anterior Cortical Cataract (ACC) Posterior Cortical Cataract (PCC) Posterior Subcapsular Cataract (PSC) Nuclear Sclerotic Cataract. Learn the truth about cataracts, how to catch them early, and how to protect your eyes and vision at any age. 35K subscribers in the optometry community. There was. Dilated examination revealed trace nuclear sclerosis and 1+ anterior cortical spoking outside the visual axis OD/OS. Closer inspection of the corneas revealed a posterior stromal haze and dense, dot-like irregularities at the level of the endothelium. 1. Author(s): Michelson, Georg, Prof. Worldwide, 20,000–40,000 children with congenital or childhood cataract are born every year, and there are an estimated 200,000 children blind from bilateral cataract. Pseudoexfoliation has long been known to be a concern when performing cataract surgery. With the Lumera, a clearer view of the anterior capsule and red reflex enables me to complete the capsulorrhexis without difficulty (Figure 4). The opalescent or milky white appearance of the nucleus with no surrounding brunescence or cortical spoking is pathognomonic. Created for people with ongoing healthcare needs but benefits everyone. Subscribe to Codify by AAPC and get the code details in a flash. Ophthalmology 11 years experience. Please refer to the LCD for reasonable and necessary requirements. Eye problems, such as previous eye injuries and inflammation, may cause cortical cataracts. The 2024 edition of ICD-10-CM H47. 80% APY 12-Month, 5. The great majority, however, are “senile” cataracts, which are apparently a part of the aging process of the. Moran CORE. Thus white for bone or stone. John Berryman answered. Cortical spoking Clinically significant diabetic macular edema Central serous (chorio) retinopathy: DCR DES DME DR DSAEK: Dacryocystorhinostomy Dry eye. yttrium-aluminum-garnet laser. This Billing and Coding Article provides billing and coding guidance for Local Coverage Determination (LCD) L38926, Cataract Extraction (including Complex Cataract Surgery). Radiation-induced cataracts are predominantly PSCs, although cortical and mixed-type cataracts have been shown . Yes: Therre are three areas of the lens that mau be affected by acquired cataract: the nucleus, the cortex and the posterior subcapsular region. ICD-10 Diagnosis Codes: H25. Advancing age. Study with Quizlet and memorize flashcards containing terms like Age, 75, Cataracts and more. clear lens devoid of aggregated dots, flecks, vacuoles and waterclefts. 01. 013 (Infantile and juvenile cortical, lamellar, or zonular cataract, bilateral). Cortical senile cataract. 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. With ICD-9 I'd use 366. 0. However, cortical changes can begin in younger age groups and may result in difficulty with night driving and glare. This study explores stroke risk factors and clinical variables that may assist in this differentiation. Dean Bonsall answered. No. 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 (availablecongenital or early in life usually don't interfere with vision Congenital nuclear, Anterior polar (pyramidal), Ubilicated, Axial fusiform, Sutural opacities, Coralliform, Persistent hyperplastic primary vitreous, Luxated lens, Zonular/lamellar, Galactosemia, Spherophakia, LenticonusFigure S4: Quantile-quantile (Q-Q) plot of observed (y-axis) vs. Please donate! Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Diagnosis: Cuneiform Cataract: Comment to photo: Peripheral, wedge-shaped cortical opacities and nucleosklerosis nasally inferior. Cortical Cataract. Early cortical cataract development as viewed at the slit lamp using retroillumination. The spoke-like streaks will steadily grow toward the center of the lens until they interfere with light passing onto the retina. The cataract looks very dense with a brunescent color behind the white cortical spoking. Cortical spokes are wedge shaped areas of clouding of the cortex. grade by quadrants-. We determined that this was a classic case. 80 OD and 0. 039. Study with Quizlet and memorize flashcards containing terms like nuclear sclerotic cataract, Blue Scleras, Episcleritis Connective tissue disease Wind, dust, chemicals, sun and more. Slit-lamp exam revealed age-related cataracts (2+ nuclear sclerosis, trace posterior subcapsular) and cortical spoking OU. 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. Fig. Any of the following abnormal retinal signs may be. Subscribe to Codify by AAPC and get the code details in a flash. The images undergo various image processing techniques to detect the presence of cataracts. No phacodonesis is evident. 1c [1]. Clearing the Fog of Cataracts clears away the confusion and misinformation around cataracts. Download Table | Mean refractive values in the nondiabetic retinopathy group from publication: Progression of nuclear sclerosis based on changes in refractive values after lens-sparing vitrectomy. Nuclear sclerosis is a condition in which the nucleus, or central part of the lens of the eye, hardens or gets cloudy. 8. Move the stage to the right (keeping forward as much as possible without physically contacting the patient), allowing the beam to fall on the patient's face. The conventional Convolution Neural Network (CNN), in conjunction with support vector machines (SVM), classifies nuclear, cortical spoking, and capsular cataract eyes. 011 for Cortical age-related cataract, right eye is a medical classification as listed by WHO under the range - Diseases of the eye and adnexa . Black dots represent all genotyped SNPs and red dots denote the imputed SNPs from CTNND2 with P<10 −5. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. Design: Retrospective cohort study. Grading helps to track how severe the cataract is, whether it’s growing or stable. and the constancy of symptoms support the concept that the pathology is cortical. . 269 may differ. Download scientific diagram | Change of nuclear sclerosis (Ns) in a typical case of the diabetic retinopathy group. U. Created for people with ongoing healthcare needs but benefits everyone. This is the American ICD-10-CM version of H47. , Shawn Lin, M. Intraocular pressures were measured as 22mm Hg OD and 21mm Hg OS. This guide from Harvard Medical School provides evidence-based solutions, tips, and resources for people who want to know more about cataract surgery or who want to delay it. 04 (anterior subcapsular polar infantile and juvenile cataract…)D. Attempts were made to contact referring ophthalmologists in patients who were lost to follow. ” The clinician did not feel her visual complaints were related to the corneal findings revealed on exam. 15 should only be used for claims with a date of service on or before September 30, 2015. sclerotic cataract, cortical spoking, posterior subcapsular cataract of more than grade 2 per Age-Related Eye Disease Study scale,15 or any other ophthalmologic condition that reduced the clarity of the media and interfered with ophthalmologic examination, surgery, or imaging of the study eye; myopia of more than fl8 diopters,The crystalline lens of his left eye showed 1+ cortical spoking, with 2+ diffuse, ground-glass posterior subcapsular changes and a denser central posterior capsular opacity. Eyes were graded on a scale of 0 to 4. The posterior segment evaluation after dilation revealed ten punched-out lesions per eye with peripapillary atrophy in both eyes. XT. The code H25. On exam, her cataracts were graded as 2+ NS (nuclear sclerotic) and 2+ cortical spoking OU. 49 Slow-motion careful tangential stripping of the cortex from anterior and posterior capsules under low-flow conditions in combination with gentle centripetal. 1. Pediatric Ophthalmology 29 years experience. cortical cataract: [ kat´ah-rakt ] opacity of the lens of the eye or its capsule. 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. No matter the frequency of eyedrop advertisements for cataract removal, surgery remains the only sure way to restore vision effectively. Subscribe to Codify by AAPC and get the code details in a flash. 3 OS Periphery: OD: lattice, pigmented sup. 269 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. IOP was consistently under 18mmHg on every visit. These lens changes were symmetric between the eyes. Code History“Crown” like, Cortical spoking Sutural Cataract Nuclear Cataract . What is. According to the WHO, there are three main types of cataracts: 1) nuclear sclerotic cataract (NS), 2) cortical spoking cataract (CS), and 3) posterior subcapsular cataract (PSC) which are shown in. Answered Jan 25, 2023. Produced by the Moran Eye Center in partnership with the Eccles LibraryAngle the light at about 45 degrees. The 2024 edition of ICD-10-CM H25. Open source ophthalmology education for students, residents, fellows, healthcare workers, and clinicians. -) 2016 (effective 10/1/2015): New code (first year of non-draft ICD-10-CM)cortical cataracts - cortical spoking increases refractive index and therefore power along that meridian - gradual change in astigmatism - look for spoking when dilated - at night patient's experience glare lens dislocation - trauma or systemic condition (Marfan syndrome - connective tissue disorder can result all over the body)Trans Am Ophthalmol Soc / Vol 102 / 2004 97 VITRECTOMY FOR EPIRETINAL MEMBRANES WITH GOOD VISUAL ACUITY BY John T. cortical cataract. In the subgroup of patients aged under 50. 3: Cortical spoking cataracts Sign in. Liberal and repeated cortical hydration and the use of viscodissection to separate the cortex from the capsule may help soften cortex material and facilitate aspiration. This peripheral part of. 562 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh with mcc; 563 Fracture, sprain, strain and dislocation except femur, hip, pelvis and thigh without mcc; 963 Other multiple significant trauma with mcc; 964 Other multiple significant trauma with cc;. Cortical Standard. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 011. A cataract-free lens is one in which the nucleus, cortex, and subcapsular areas are free of opacities; the subcapsular and cortical zones are free of Of the three, nuclear sclerotic and cortical spoking are more prevalent than PSC, each being graded according to severity of lens opacities. The VCTS contrast sensitivity plates, the Miller-Nadler glare tester, Baylor visual function tester, and the Stereo Optical glare tester were used. DIAGNOSIS: Nuclear cataract with cortical spoking, right eye, 366. We also noted posterior vitreous detachment. Cigarette smoking. To be aware of the risk factors for cataract. “Water clefts” appear to begin as splits in suture lines, with remnants of. Her cup-to-disc ratios were 0. ICD-10-CM Codes. 1 If age is the main risk factor for cataract progression, pseudoexfoliation syndrome (PXF) represents an independent additional hazard for the development of nuclear sclerosis. Business, Economics, and Finance. 35 became effective on October 1, 2023. Request a Demo 14 Day Free Trial Buy Now. Retroillumination of the lens. more extensive opacification with small minispokes. 0):. Dark/hypoechoic texture is usually better. Cortical spoking cataract (CS) - Swelling of the cortex causing spoke/wedge-like peripheral cloudiness. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. , Shawn Lin, M. No phacodonesis is evident. Study with Quizlet and memorize flashcards containing terms like Thickest Anteriorly Thinnest Posteriorly, 2/3 water 1/3 protien, Anaerobic metabolism and more. Any kind of "cortical involution" (i. Slit-lamp examination demonstrated bilateral combined cataracts of 3+ nuclear sclerosis, 1+ cortical spoking, and 1+ posterior subcapsular opacity. D. Cortical cataracts develop when the more peripheral lens fibers. Andrew Dahl answered. 013 is applicable to adult patients aged 15 through 124 years. White cataracts, characterized by a golden center and cortical spoking, clefting or cracking, adhesions to the capsule, and severe cortical opacification. Created for people with ongoing healthcare needs but benefits everyone. Define spoking. CII cortical spoking that obscures more than 2 full quadrants. ICD-9-CM 366. A patient with both OSD and cataracts begs the age-old visual impact question, which came first? Regardless of the answer, the first step is aggressively treating the OSD prior to a cataract consultation.