In some parts of the world, dense white cataracts are relatively uncommon, but in other areas, these are seen and treated just about every week. Los Angeles, my hometown, is a very large and diverse city and we have the full range of cataract cases presenting to our clinics every week. We have some patients with mild, "California Cataracts" and 20/40 vision, but we also have patients presenting with severe cataracts and visual acuity of 20/400 or worse.

An important issue in patients with a white cataract is differentiating the sub-type prior to going to the operating room. We had an entire week of white cataract cases presented here at CataractCoach, so I encourage you to review those videos as well.

In the video presented here, the patient has a dense white nuclear cataract with cortex that is relatively clear and not liquified. This means that this case is not an intumescent white cataract and the risk of Argentinian Flag Sign is quite low. The nucleus is also relatively fibrous so that the initial chop has difficulty propagating completely. We address this issue by sub-chopping into small nuclear chunks which can then be easily phaco-aspirated.

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