Not all white cataracts are the same

All white cataracts are not the same. They can run the spectrum from soft to very dense, with a variable degree of cortical liquefaction, and presence or absence of confounding issues.

These are the three main questions to ask when you see a white cataract. (1) is it intumescent (fluid-filled)?; (2) is the nucleus dense or soft?; (3) are there associated issues?
White cataracts can be anywhere from a bluish white to a yellowish white.
A slight bluish tint can be seen when the cortex is liquefied producing an intumescent, pressurized cataract.
The yellowish tint can imply less liquefaction of the cortex. The central nucleus has higher density while the epi-nuclear shell is less opaque.
Other associated abnormalities may include (A) traumatic loss of zonular support, (2) prolapse of the entire nucleus in the AC after a car accident, (3) congenital focal zonular absence, and (4) congenital aniridia.

click below to learn from this review of white cataracts and cataract surgery: