. Four of those were among the surgeon's first 65 DSEK cases, starting in 2003, when aspects of the DSEK technique were still early in development. View Full Image. Study with Quizlet and memorize flashcards containing terms like nuclear sclerotic cataract, Blue Scleras, Episcleritis Connective tissue disease Wind, dust, chemicals, sun and more. 1. A 'billable code' is detailed enough to be used to specify a medical diagnosis. 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. This is a normal part of the aging process called nuclear sclerosis. Please refer to the LCD for reasonable and necessary requirements. Quetiapine was tapered off over 9 days, and an eye examination conducted. Posterior segment of the left eye shows a dense vitreous hemorrhage with a positive red reflex. yttrium-aluminum-garnet laser. 032 (left eye) - H26. Eyes were graded on a scale of 0 to 4. Slit-lamp examination demonstrated bilateral combined cataracts of 3+ nuclear sclerosis, 1+ cortical spoking, and 1+ posterior subcapsular opacity. Change in perception of colors. Nuclear Sclerotic Cataracts. This is the American ICD-10-CM version of H25. 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. in a. 35 OD 0. Official Long Descriptor. 1. 80 OD and 0. 619 became effective on October 1, 2023. Slit-lamp exam revealed age-related cataracts (2+ nuclear sclerosis, trace posterior subcapsular) and cortical spoking OU. The spokes gradually grow towards the center of the lens and blur vision. 4: Posterior subcapsular cataracts Sign in. Created for people with ongoing. We review the basics of radiation dose and the potential radiation effects, particularly as they pertain to the operator. Dr. No phacodonesis is evident. 03 : H00-H59. Scenario: A 72-year-old patient presents to the practice with blurred vision and slight yellow tinting to the left eye. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. Coding Guidance. Please donate! Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Short description: Infantile and juv cortical/lamellar/zonular cataract, r eye; The 2024 edition of ICD-10-CM H26. Eyes were graded on a scale of 0 to 4. X (T) exotropia. When using code H25. At that time she was also noted to have generalized ocular surface disease (OSD) with superficial punctate keratitis (SPK), a decreased tear break-up time, a scant tear prism and worsening comfort as the day progressed. Methods: The visual results and. Andrew Dahl answered. PSCs may also be seen with steroid use and diabetes, which can confound assessment of cataract cause . Senile cataracts are classified into three main types: nuclear cataract, cortical cataract, and posterior subcapsular cataract. 0. 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 . 16 & 366. There is actually a wide variety of symptoms caused by cataracts: Blurry vision. , Shawn Lin, M. Depending on the location of the opacities, as shown in Fig. Posterior Subcapsular Cataracts. IOP was consistently under 18mmHg on every visit. 61 - other international versions of ICD-10 H47. The phakic IOL is well positioned but may exhibit slight temporal displacement. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. Code History“Crown” like, Cortical spoking Sutural Cataract Nuclear Cataract . They were characterised by the onset of a lenticular. Created for people with ongoing healthcare needs but benefits everyone. Cortical age-related cataract, unspecified eye. The opacity did not seem to be contiguous with the posterior capsule, nor was there a clearly defined space between the two. ; however, these changes were mild and inconsistent with his reduced vision. Posterior Subcapsular: The area at the back of the lens develops cloudiness. Learn faster with spaced repetition. BILLABLE Adult Only | ICD-10 from 2011 - 2016. 5–3. Central retinal artery occlusion. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. When we see this gap it is often associated with zonular laxity which allows the cataract to fall towards the vitreous cavity. Discover the truth about whether you really need cataract surgery. What is. Coding Guidance. Dean Bonsall answered. 2. 71%, while for a three-class classification, 83. 012. We hypothesized that exposure to unclean cooking fuels (ie, wood or kerosene) would be associated with the following: (1) the severity of nuclear sclerotic, cortical spoking, and posterior subcapsular (PSC) cataract in a cross-sectional analysis of baseline data; and (2) cataract progression, measured by a proxy of cataract surgery in a. P0 Clear posterior capsule. Similarly, the estimated amount of posterior subcapsular cataract (P) is determined by comparing it to another 5 photographs depicting increasing amounts of posterior subcapsular cataract. 011 - other international versions of ICD-10 H25. 2 Nuclear Nuclear cataracts are the most common age-related cataract, characterised by opaci-fication of the central portion of the lens. Description. Comments. Cancel anytime. S. 2 OD, 0. 269 - other international versions of ICD-10 H05. It means "not coded here". See a neurologist for guidance. Wedge-shaped (cuneiform) or spoke-like (wheel) peripheral changes are seen. Posterior subcapsular haze? A posterior subcapsular cataract reveals a "frost-like" haze just anterior to the pos-terior lens capsule which is the back sur-Will present with cortical spoking with vacuoles between lens fibers due to cortical hydration. 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. 011 became effective on October 1, 2023. Or, simply reference the most commonly used abbreviations the old fashioned way. ICD-10-CM Code for Cortical age-related cataract, bilateral H25. Eye problems, such as previous eye injuries and inflammation, may cause cortical cataracts. This can progress to such a degree that itTypical age-related cataracts present with diffuse nuclear sclerosis and some degree of cortical spoking. Nuclear sclerosis is a condition in which the nucleus, or central part of the lens of the eye, hardens or gets cloudy. Where will they synapse?Age-related cataract typically has three components: nuclear sclerosis, cortical spoking, and posterior subcapsular haze. How would you proceed? Which IOLs would you consider? —Case prepared by Audrey R. Vision can be affected in various ways, depending on exact location and prominence of these spokes. For claims with a date of service on or after October 1, 2015, use an equivalent ICD-10-CM code (or codes). Posterior subcapsular cataract (PSC) – Opacity in the posterior capsule of the lens, often seen in younger individuals, steroid users, and diabetics. Cornea, Cataract, & Refractive (LASIK & PRK) Surgery 20 years experience. Each affects a different part of the lens and has different symptoms and progression, although the indication for intervention with all types is the same. Dr. H25. 다른 모든 것이 동일할 때 일반적으로. Request a Demo 14 Day Free Trial Buy Now. Create flashcards for FREE and quiz yourself with an interactive flipper. The three main types are: Posterior subcapsular. 65/0. XT. 811 (for right eye) when he says they have nuclear sclerosis cataract and senile cortical cataract. 3 OS. Refer to NCCI and OPPS requirements prior to billing Medicare. Talk to a doctor now . Based on the annual CPT/HCPCS updates, this article was revised to change the long descriptor information for codes 66982, 66983, and 66984. 041--Posterior subcapsular polar senile cataract, right eye H25. Symptoms of Cortical Cataracts. Caused by swelling and liquefaction of the cortical fiber cells. 35 - other international versions of ICD-10 Z68. Chronic alcoholism. The opalescent or milky white appearance of the nucleus with no surrounding brunescence or cortical spoking is pathognomonic. Cataract/Anterior Segment. This is the American ICD-10-CM version of H47. However, cortical changes can begin in younger age groups and may result in difficulty with night driving and glare. What is cortical spoking (CS)? A posterior subcapsular cataract reveals a "frost-like" haze just anterior to the posterior lens capsule which is the back surface of the lens on slit lamp examination. Posterior subcapsular cataracts start as small cloudy or opaque areas on the back surface of the eye lens, beneath the lens capsule that encloses and holds the lens in place. What is a cortical spoking cataract? Moderate cortical changes. 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. Corneal topography or tomography. 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. 03 may differ. Grading helps to track how severe the cataract is, whether it’s growing or stable. A “Morgagnian“ cataract, is an extremely difficult case because the center is liquefied, increasing risk of dropping the nucleus into the vitreous during surgery. you can tell it's an anterior cortical cataract because the iris is still pretty clear and in focus. Identifying the Severity Cataracts are lens opacities that blur visual images, leading to symptoms like glare, halos, and photosensitivity – one of the leading causes of blindness worldwide. If it gets severe enough, it becomes a nuclear. We present seven patients with oil-drop cataracts referred for neuro-ophthalmologic. A variety of cannula are available for this maneuver, though a surgeon should default to the equipment with. Nuclear sclerosis is a condition in which the nucleus, or central part of the lens of the eye, hardens or gets cloudy. 03 - other international versions of ICD-10 H25. 0 mm pupil in the cortical, nuclear, and posterior subcapsular cataract groups. This article contains coding and other guidelines that complement the local coverage determination (LCD) for Cataract Extraction. Low-level vision features are used to characterize the photometric appearances and geometric structures of cortical and PSC cataracts in retroillumination images. Study Ocular Disease Midterm flashcards. Pediatric Ophthalmology 29 years experience. Prior inflammation/injury of the eyes. Explanation: "Cortical Cataracts. There are three primary types of cataracts: nuclear sclerotic, cortical, and posterior subcapsular they also have unique symptoms which are discussed below. 5A. Glare and / or difficulty driving at night. Mature cataract . Cortical Cataracts. A type 1 excludes note is for used for when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. On exam, her cataracts were graded as 2+ NS (nuclear sclerotic) and 2+ cortical spoking OU. In the subgroup of patients aged under 50. There are three primary types of cataracts: nuclear sclerotic, cortical, and posterior subcapsular they also have unique symptoms which are discussed below. The 2024 edition of ICD-10-CM H25. Advancing age. , adj catarac´tous. 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. Some cataracts result from injuries to the eye, exposure to great heat or radiation, or inherited factors. Produced by: Brandon Pham. 35K subscribers in the optometry community. Pseudoexfoliation syndrome (also called PXF, PXE or PEF) involves these parts of the eye: Aqueous humor. 013 is applicable to adult patients aged 15 through 124 years. Diagnosis: Cuneiform Cataract: Comment to photo: Peripheral, wedge-shaped cortical opacities and nucleosklerosis nasally inferior. It's one of the most common types of cataracts. A cataract grading system was developed by a panel of experts with the objective of making available a simple system for use with a slit lamp to allow for the reliable grading of the most common forms of cataract by relatively inexperienced observers. This is the most common form of cataract. 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 . Figure 8-12. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. Official Long Descriptor. intermittent exotropia. -) 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. What is a nuclear sclerotic cataract? How will it present?. Cigarette smoking. Cortical Cataract Grading. Learn how we can help. However, this is only a short term solution as the cortical. Any kind of "cortical involution" (i. 35 became effective on October 1, 2023. Posterior subcapsular (by degree of posterior capsule obscured) 3%. The optometrist diagnoses the. Anterior segment exam revealed a moderate nuclear sclerotic and cortical spoking cataract OD and an early nuclear sclerotic cataract OS. This is the most common form of cataract. Phacoemulsification surgery has proven itself effective with its positive correlation to CDE scores. IOP measured 18 mm Hg OU. The 2024 edition of ICD-10-CM H25. This is the American ICD-10-CM version of H26. Type in any ophtho term to this translator or copy and paste entire notes to finally decode all those abbreviations. The remainder of the examination is normal. 01 - other international versions of ICD-10 H25. Type in any ophtho term to this translator or copy and paste entire notes to finally decode all those abbreviations. Purpose: To evaluate objectively intraocular scattering in eyes with nuclear, cortical and posterior subcapsular cataracts by means of an objective scatter index (OSI) obtained from double-pass images. Draft article posted on 01/14/2021. Obstetrics and Gynecology 56 years experience. 1. 039 is a valid billable ICD-10 diagnosis code for Anterior subcapsular polar age-related cataract, unspecified eye . Cortical spoking cataract (CS) – Swelling of the cortex causing spoke/wedge-like peripheral cloudiness. Blurry lines that affect vision. Study with Quizlet and memorize flashcards containing terms like What are the three parts of the crystalline lens?, What is the refractive power of the lens?, What are the dimensions of an adult lens? and more. Image License and Citation Guidelines. Anterior segment exam revealed a moderate nuclear sclerotic and cortical spoking cataract OD and an early nuclear sclerotic cataract OS. An ocular health evaluation revealed early nuclear sclerosis and cortical spoking O. Posterior subcapsular cataract (PSC) – Opacity in the posterior capsule of the lens, often seen in younger individuals, steroid users, and diabetics. 011 may differ. 35 OD 0. This is the American ICD-10-CM version of Z68. 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. Changes in the water content of the lens fibers create clefts, or fissures, that look like the spokes of a. Coding Guidance. 8 in both eyes, and ancillary testing revealed significant retinal nerve fiber layer (RNFL) deficits on optical coherence tomography (OCT) of both eyes. 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. The stereo coaxial illumination extends. 35 OD 0. Learn vocabulary, terms, and more with flashcards, games, and other study tools. 2024 ICD-10-CM Range H00-H59. 039 (unspecified eye) H26. 011 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Because the patient’s cortical cataracts affect both eyes, you’ll select H26. The 2024 edition of ICD-10-CM H47. true. 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. 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. ICD-10-CM Code H25. Created for people with ongoing healthcare needs but benefits everyone. , decrease in normal mass) can affect cerebral function. I measured contrast sensitivity and glare in 51 cataract patients who had Snellen visual acuities of 20/60 or better. The other source of monocular diplopia is refractile inhomogeneity in the crystalline lens, where cortical spoking makes the image jump a bit as you move back and forth with a monocular ophthalmoscope. The clear, watery fluid in the front of the eye that provides the eye with nourishment, removes waste, and maintains normal eye shape and pressure. . . Cortical visual impairment can. The membranes of mature lens fibre cells are disrupted, resulting in protein oxidation and precipitation of cellular material. injury (trauma) of eye and orbit ( S05. . They may be peripheral only and therefore cause no symptoms. 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. Purpose: To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking cataracts. 4/24/2018 12 Complete/White Systemic DiseaseOn exam, her cataracts were graded as 2+ NS (nuclear sclerotic) and 2+ cortical spoking OU. 5 per 10,000 children, with most occurring within the first year of life. 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 . and 20/70 O. 0):. Senile cataract is a yellowing of the entire. 2: Nuclear sclerotic cataracts. Then we present the data regarding the risk of each type of radiation effect to the fluoroscopy. The prevalence of senile cortical and senile posterior subcapsular cataract is about 28% and 20% respectively. 3%) in our study, the second most prevalent sign of elevated lipid levels. Please refer to the LCD for reasonable and necessary requirements. 40 round with healthy rim tissue OD, OS, without neovascularization of the disc (NVD). 269 may differ. Download scientific diagram | Change of nuclear sclerosis (Ns) in a typical case of the diabetic retinopathy group. Create flashcards for FREE and quiz yourself with an interactive flipper. To obtain quality HRT-3 (Heidelberg) and OCT images, the patient was dilated in the usual fashion. 3. 013 . Cortical Cataracts. Cornea, Cataract, & Refractive (LASIK & PRK) Surgery 20 years experience. “Water clefts” appear to begin as splits in suture lines, with remnants of. In this paper, we propose an automatic approach to grade cortical and Posterior Sub-Capsular (PSC) cataracts using retroillumination images. The deep learning model identifies the type. Read More. Which of the following is not handy when diagnosing RP? A. 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. The optic nerves were 0. , "Progressive reduction in cortical thickness as psychosis develops: a multisite longitudinal neuroimaging study of youth at elevated. Study with Quizlet and memorize flashcards containing terms like What is nuclear sclerosis?, What is the etiology of nuclear sclerosis?, What are the typical demographics of patients with nuclear sclerosis? and more. 61 contain annotation back-references that may be applicable to H47. 013 (Infantile and juvenile cortical, lamellar, or zonular cataract, bilateral). Nuclear sclerosis is common in older adults as part of the aging process of the eye and can lead to. Cataracts that start growing at the outer edge of the lens are called cortical cataracts. The following code (s) above H47. 1 (Cary, North Carolina, USA) was used for all statistical analyses. The typical symptoms that come with cortical cataracts include: Increased difficulty driving at night. 011Cortical age-related cataract, right eye. protein aggregation b. B, Typical cortical spokes. A 60-year-old member asked:. ICD-10 Diagnosis Codes: H25. There was no evidence of pseudoexfoliation. The images undergo various image processing techniques to detect the presence of cataracts. [Show full abstract] support vector machines (SVM), classifies nuclear, cortical spoking, and capsular cataract eyes. 0 using the lens opacities classification system LOCS II before and after pars plana. The center of your lens turns yellow and gets harder as you age. more extensive opacification with small minispokes. Nuclear sclerotic, cortical (‘spoking’), and subcapsular cataracts will comprise the vast majority of those seen in clinic. Views 491. Brain problem: Cortical visual impairment is when visual function is affected by changes in the brain rather than changes in the eye. CII. tous changes. A, Fundus autofluorescence photograph of the right eye showing slight radial hypofluorescence around the fovea corresponding to cortical spoking. The key causes of cortical cataracts are eye injury, aging, and a family history of cataracts. 15. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. Optic nerve head,. 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. 2. Add to My Bookmarks. The left eye showed an old branch vein occlusion in the superotemporal region, with extensive retinal venous collaterals. Her cup-to-disc ratios were 0. Article Text. D. Full-Field ERG E. GVF OD with temporal scotoma. Her cornea also demonstrated a polygonal pattern of opacities in the posterior stroma with clear intervening spaces, resembling a “crocodile. Study with Quizlet and memorize flashcards containing terms like Thickest Anteriorly Thinnest Posteriorly, 2/3 water 1/3 protien, Anaerobic metabolism and more. The 2024 edition of ICD-10-CM H25. Cortical cataracts develop when the more peripheral lens fibers. This is the American ICD-10-CM version of H25. 042--Posterior subcapsular polar senile. These changes may be extensive but may not affect. The amount of cortical cataract (C) is determined by comparing the estimated aggregate of cortical spoking to that seen in 5 separate photographs. The oil-drop cataract is a common yet often overlooked cause of progressive vision loss. 3: Cortical spoking cataracts Sign in. Disorders of lens. H25. Nuclear sclerosis and cortical spoking accounted for moderate reduced visual acuity in both eyes (OU). 피질 스포킹 백내장(Cortical spoking cataract, CS) – 스포크/쐐기형 주변 흐림을 유발하는 피질의 부종. Cortical spoking cataract (CS) - Swelling of the cortex causing spoke/wedge-like peripheral cloudiness. reveals an anterior subcapsular cataract with cortical spoking. An ocular health evaluation revealed early nuclear sclerosis and cortical spoking O. 013 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. Subscribe to Codify by AAPC and get the code details in a flash. 50% APY 30-Month CD Rate Special (AZ) More. Dr. One of the rods or braces connecting the hub and. The phakic IOL is well positioned but may exhibit slight temporal displacement. 1. It has little or no effect on vision, but the blue-gray appearance of the lens often prompts a misdiagnosis of cataract. Age-related cataract (H25) Cortical age-related cataract (H25. Cortical cataract demonstrating white cortical spoking. To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking. The center of your lens turns yellow and gets harder as you age. a cortical spoking cataract is often first seen where due to sun exposure? inferonasal. -goes up to 4, but everyone does it differently-Some grade appearance-Others: appearance + VAs-does not matter for insurance purposes. At that time she was also noted to have generalized ocular surface disease (OSD) with superficial punctate keratitis (SPK), a decreased tear break-up time, a scant tear prism and worsening comfort as the day progressed. Cataract scoring for the first 6. This is the American ICD-10-CM version of H47. Seen on slit lamp examination 22. Jimmy T. Open source ophthalmology education for students, residents, fellows, healthcare workers, and clinicians. Simply stated, a cataract is present when the physiologi. Study SCLERAL, LENS OCULAR DISEASE flashcards. Subscribe to Codify by AAPC and get the code details in a flash. 03 contain annotation back-references that may be applicable to H25. 59% APY 6 & 18-Month Jumbo (Nationwide) AEA Federal Credit Union CD Promotion: 3. 15 should only be used for claims with a date of service on or before September 30, 2015. (C) A higher magnification of an Arvcf−/− lens with a disruption at the. 61 may differ. 019. cortical spoking. Study with Quizlet and memorize flashcards containing terms like Dermatochalasis, Cell & Flare, Pinguecula and more. . Lens: cortical opacities, 1+cortical spoking OU 2+PSC Disc: staphyloma OU, oblique insertion C/D: 0. Cortical opacities were twice as prevalent as Achilles tendon thickening (16. H25. Create flashcards for FREE and quiz yourself with an interactive flipper. He had 2-3+ nuclear sclerosis and 2+ cortical spoking in both eyes. 0 mm incisions placed 2. 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. Michael Gabor answered. 67mm 2 14yo African American Female VA: cc through CL Distance. Cortical Spoking: Because of swelling in the cortex, spoke-like cloudiness develops on the outer edge of the lens. 4: Posterior subcapsular cataracts Sign in. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. Nuclear sclerosis is common in older adults as part of the aging process of the eye and can lead.