Cortical Cataract. Sure, kids will have congenital cataracts, and certain medications or. The optometrist diagnoses the. PSCs may also be seen with steroid use and diabetes, which can confound assessment of cataract cause . 1. Brain problem: Cortical visual impairment is when visual function is affected by changes in the brain rather than changes in the eye. how do you grade a CS? consider the amount of lens tissue affected. 041--Posterior subcapsular polar senile cataract, right eye H25. 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 lack of monocular or homonymous visual field defect makes. 013 (Infantile and juvenile cortical, lamellar, or zonular cataract, bilateral). No matter the frequency of eyedrop advertisements for cataract removal, surgery remains the only sure way to restore vision effectively. Main Outcome Measures. 후낭하 백내장(PSC) – 수정체 후낭의 혼탁으로 젊은 사람, 스테로이드 사용자 및 당뇨병 환자에게 자주 나타납니다. The stereo coaxial illumination extends. The images undergo various image processing techniques to detect the presence of cataracts. Nuclear sclerosis and cortical spoking accounted for moderate reduced visual acuity in both eyes (OU). 032 (left eye) - H26. H25. ANA is neg. Cortical Cataract. 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. S. 04 : H00-H59. Both lenses show 2+ cortical spoking and 1+ nuclear sclerosis, consistent with 20/40. yttrium-aluminum-garnet laser. 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. Eyes Forward – Cataracts – Part 1: Choosing When To Proceed With Surgery – 01. Methods: Records of consecutive patients with acute. C0. The diagnosis of PXF is aided by characteristic findings. cortical cataract. 5A. 2: Nuclear sclerotic cataracts. The phakic IOL is well positioned but may exhibit slight temporal displacement. Read More. Posterior segment exam shows no abnormality and the fundus pigmentation is normal OU. (Main entry Extraction, cataract directs. Now with ICD-10 his office schedules with ICD-10 H25. 013 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2024 edition of ICD-10-CM H25. We determined that this was a classic case. She was also found to have anterior and posterior cortical spoking of the crystalline lenses, off the visual axis. They were characterised by the onset of a lenticular. 1. ICD-10-CM S43. Created for people with ongoing healthcare needs but benefits everyone. 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. Cataracts symptoms floaters. What is a cortical spoking cataract? Moderate cortical changes. tous changes. 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. Cataracts that start growing at the outer edge of the lens are called cortical cataracts. Lens: cortical opacities, 1+cortical spoking OU 2+PSC Disc: staphyloma OU, oblique insertion C/D: 0. 3 OS Periphery: OD: lattice, pigmented sup. 011 became effective on October 1, 2023. 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. Often, a shift in nearsightedness is noted, ranging from one to six diopters. One of the rods or braces connecting the hub and. This is the American ICD-10-CM version of H05. D. 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. Given that the likely cause of her decreased objective visual acuity was her. The code H25. 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) EsophoriaExcellent cortical cleaving hydrodissection as described by Howard Fine in 1992 is a key step in mobilizing the lens within the capsular bag so as to minimize stress on the intact zonular fibers during lens rotation and nuclear disassembly. 012. , Shawn Lin, M. cortical spoking. 4: Posterior subcapsular cataracts Sign in. Cataract caused by blunt trauma that can be anterior or posterior subcapsular and is shaped like a floweranterior cortical lenticular changes and to ascertain the precise position of the IOL. Andrew Dahl answered. White cataracts, characterized by a golden center and cortical spoking, clefting or cracking, adhesions to the capsule, and severe cortical opacification. The median age at diagnosis is 46 years. 019 became effective on October 1, 2023. There is actually a wide variety of symptoms caused by cataracts: Blurry vision. 3: Cortical spoking cataracts Sign in. 4 Cataracts were evaluated at the time of the preoperative visit closest to the date of surgery and on all subsequent postoperative visits. 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. It occurs when small spokes begin to develop around the edge of the lens. 2024 ICD-10-CM Range H00-H59. , Shawn Lin, M. 15. ; however, these changes were mild and inconsistent with his reduced vision. 0. Optic nerve head,. This is the American ICD-10-CM version of H26 - other international versions of ICD-10 H26 may differ. The deep learning model identifies the type. Chronic open-angle glaucoma. It can be treated with surgery to replace your lens with an artificial one. Using dark-field stereomicroscopy, we photographed donor lenses in toto and as thick slices. yttrium-aluminum-garnet laser. ; however, these changes were mild and inconsistent with his reduced vision. 1. [ 2]Disease. Closer inspection of the corneas revealed a posterior stromal haze and dense, dot-like irregularities at the level of the endothelium. 0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular. The 2024 edition of ICD-10-CM H05. YAG. 3 OS. 013 . Advancing age. 3 OD OS ERM Central atrophy with RPE hyperplasia Fine NVE??? Thoughts BRVO? OIS?tions werenormal, except for early cortical catarac-Correspondence to Lee M. CII cortical spoking that obscures more than 2 full quadrants. Cortical Spoking Explanation: - PSC is more of a concern. 5: Posterior capsular opacifications Sign in. Learn how we can help. In our office, his best-corrected visual acuity measured 20/50 O. 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. D. The remainder of the examination is normal. Cortical visual impairment can. 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 . 4/24/2018 12 Complete/White Systemic DiseaseOn exam, her cataracts were graded as 2+ NS (nuclear sclerotic) and 2+ cortical spoking OU. intermittent exotropia. change in the cortex of the posterior lens of the eye. 269 became effective on October 1, 2023. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Subscribe to Codify by AAPC and get the code details in a flash. 4: Posterior subcapsular cataracts Sign in. The area of kideney fuction, filtration ; reabsorbtion. Please donate! Funds go solely to hosting and development costs that allow medical practitioners around the globe to freely access WikEM. Cataract: In the context of cataract formation, cortical spoking refers to the peripheral and superficial (cortex) clouding of the lens in the pattern of spokes. To compare the results with those obtained using clinical conventional procedures. 피질 스포킹 백내장(Cortical spoking cataract, CS) – 스포크/쐐기형 주변 흐림을 유발하는 피질의 부종. 039 is a valid billable ICD-10 diagnosis code for Anterior subcapsular polar age-related cataract, unspecified eye . 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. Start studying OTM 4 - Lecture 1 Lens and Vitreous. Get the Free App for Members. 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. Her cornea also demonstrated a polygonal pattern of opacities in the posterior stroma with clear intervening spaces, resembling a “crocodile skin. 04 (anterior subcapsular polar infantile and juvenile cataract…)D. Study with Quizlet and memorize flashcards containing terms like Age, 75, Cataracts and more. They initially manifest as white wedge-like opacities or streaks on the lens’s outer edge. 2: Nuclear sclerotic cataracts. Create flashcards for FREE and quiz yourself with an interactive flipper. expected (x-axis) P-values from genome-wide association tests for the bivariate outcome of cortical cataract and temporal horn volume. Symptoms of Cortical Cataracts. The principal opportunities for intra-operative lens trauma occur during removal of dysfunctional recipient endothelium and Descemet. P0 Clear posterior capsule. In this case, there is no serious zonular laxity. The optic nerve showed a cup-to-disc ratio of 0. T/F cortical spoking and PSC can be best graded with retroillumination of the LENS. Study iris and lens flashcards. 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. 6: Artificial lenses Sign in. Methods: In this prospective, observational, cross-sectional, non. There are three primary types of cataracts: nuclear sclerotic, cortical, and posterior subcapsular they also have unique symptoms which are discussed below. 0 using the lens opacities classification system LOCS II before and after pars plana vitrectomy for macular. 51 ). The remainder of the examination is normal. Read More. 2024 ICD-10-CM Range H00-H59. 2 Genetic mutations account for the majority of cases of bilateral. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. Dean Bonsall answered. cortical spoking. CME MONOGRAPH Ophthalmology Insights ™ Case Studies in Dry Eye Disease, Glaucoma, and Diabetic Macular . 03 may differ. 1. The risk factors include –. This is the American ICD-10-CM version of H47. 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. Main Outcome Measures. ICD-10 code H25. What are the symptoms of cortical spoking cataract? The symptoms of cortical spoking cataract can include blurred or hazy vision, difficulty seeing in. A 60-year-old member asked:. Any of the following abnormal retinal signs may be. The membranes of mature lens fibre cells are disrupted, resulting in protein oxidation and precipitation of cellular material. However, this is only a short term solution as the cortical. This peripheral part of the lens is call the cortex hence the term cortical spoking. To measure the rate of cataract development and progression of nuclear sclerotic cataracts (NSC), posterior subcapsular cataracts (PSC), and cortical spoking. Diabetes. Here, surgeons share their experience and advice for. There was no evidence of pseudoexfoliation. 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. Eyes were graded on a scale of 0 to 4. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. The results of eye examinations at baseline, 6 months, and 12 months were unremarkable. ’; ‘. The code is valid during the current fiscal year for the submission of HIPAA-covered transactions from October 01, 2023 through September 30, 2024. 1 In the UK, childhood cataract affects 2. Intraocular pressures were measured as 22mm Hg OD and 21mm Hg OS. Cortical Degeneration. She was also found to have anterior and posterior cortical spoking of the crystalline lenses, off the visual axis. 5A. Cataracts cause more than blurry vision. . The left eye was otherwise unremarkable. 013 is applicable to adult patients aged 15 through 124 years. Is cortical spoking a type of cataract? Dr. a cortical spoking cataract is often first seen where due to sun exposure? inferonasal. The left eye shows 2+ nuclear sclerosis with 2+ cortical spoking. RA Factor - neg. GameStop Moderna Pfizer Johnson & Johnson AstraZeneca Walgreens Best Buy Novavax SpaceX TeslaType of cataract was also recorded (nuclear sclerosis, cortical spoking, posterior subcapsular). 03 contain annotation back-references that may be applicable to H25. terior subcapsular cataract, cortical spoking), with each rated on a scale from clear to 4+. Cortical cataracts develop in the lens’s cortex, encircling the central nucleus. Data collected on these patients included age, ethnicity, sex, preoperative best-corrected visual acuity, cataract grade (nuclear sclerosis vs cortical spoking vs posterior subcapsular), lens thickness, first versus second eye, right versus left eye, birth month and insurance status. They were characterised by the onset of. Subjects: Twenty-six eyes of 26 patients><50 years of age that had. 2 with collaterals 0. 1. An anterior subcapsular cataract is evident, and a Visian ICL is. Attempts were made to contact referring ophthalmologists in patients who were lost to follow. The following code (s) above H25. 0 using the lens opacities classification system LOCS II before and after pars plana. minimal degree of cortical opacification and/or minispoke formation. cortical cataract: [ kat´ah-rakt ] opacity of the lens of the eye or its capsule. It is more common in people with diabetes and hypertension. The change from nuclear sclerosis or cortical spoking to frank cataract formation is gradual. While the majority of cataracts in the population are age-related, or senile, cataracts, there are many types and causes of cataract. Dilated fundus examination revealed 1+ nuclear sclerosis, 1+ anterior cortical spoking, and 2+ posterior capsular cataracts OU. It begins at the nucleus of the eye (the central zone). Nuclear sclerotic cataracts (NS) involve cloudiness in the lens’s nucleus; cortical spoking cataracts (CS), on the other hand, form spoke- or wedge-shaped areas with cloudiness on their outer edges that is cloudy in areas. The proposed method was successful in accurately classifying the two classes. #1. ICD-10 Diagnosis Codes: H25. Diagnosis 2: Nuclear Cataracts. Upon evaluation of the lenses, the patient had grade two nuclear sclerosis in both eyes, along with cortical spoking greater in the right eye than in the left. Quetiapine was tapered off over 9 days, and an eye examination conducted. 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. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. Cortical spoking cataract (CS) - Swelling of the cortex causing spoke/wedge-like peripheral cloudiness. 8 in both eyes, and ancillary testing revealed significant retinal nerve fiber layer (RNFL) deficits on optical coherence tomography (OCT) of both eyes. 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. Lens: Trace nuclear sclerosis and cortical spoking OU; Dilated fundus examination (DFE): Vitreous: Normal OU; Disc: Normal, pink optic nerves OU; Cup-to-disc ratio: 0. There was no evident phacodonesis. Cortical opacities were twice as prevalent as Achilles tendon thickening (16. 80% APY 12-Month, 5. Eyes were graded on a scale of 0 to 4. Cancel anytime. The white lines in B represent a transparent region that is superficial to the opaque region. 2: Nuclear sclerotic cataracts. As they progress, these streaks gradually move toward the center, taking on an appearance similar to spokes in a bicycle wheel. Coding Guidance. 013 became effective on October 1, 2023. 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. 1: Anatomy of the lens. We have assembled a list of common abbreviations that you are bound to encounter. C-Reactive Prot, Quant - 79. 85mm OS: 32. Disorders of lens. Fundus examination revealed optic nerves with distinct margins and intact rim tissue with cup-to-disc ratios. 67mm 2 14yo African American Female VA: cc through CL Distance. Echotexture is nil or black through water ; becomes progressively more white as tissus becomes more dense. Approximate Synonyms. The 2024 edition of ICD-10-CM Z68. 013 may differ. When we see this gap it is often associated with zonular laxity which allows the cataract to fall towards the vitreous cavity. For example, if you observe cortical spoking and nuclear opacification, your patient likely has both cortical and nuclear sclerotic. 042--Posterior subcapsular polar senile. 5 per 10,000 children, with most occurring within the first year of life. 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. Cortical spokes are wedge shaped areas of clouding of the cortex. ICD-10-CM Coding Rules. Retroillumination of the lens. After the type of cataract is figured out, then it will be graded. They form lines that then move towards the center of the lens, like the spokes of a wheel. Description. An examination of the anterior segment of the right eye reveals an anterior subcapsular cataract with cortical spoking. ICD-10 code H25. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. . formación de rayos de rueda en la corteza. 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. Learn how to grade nuclear sclerosing, cortical spoking, and posterior subcapsular cataracts. Main Outcome Measures. Angles were open to scleral spur 360 degrees OD, OS without any abnormalities. Dr. 619 - other international versions of ICD-10 H47. 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. The great majority, however, are “senile” cataracts, which are apparently a part of the aging process of the. Study with Quizlet and memorize flashcards containing terms like Cerulean, Cerulean, Sutural and more. 0 using the lens opacities classification system LOCS II before and after pars plana. 1. Eyes were graded on a scale of 0 to 4. 6: Artificial lenses Sign in. Create flashcards for FREE and quiz yourself with an interactive flipper. The 2024 edition of ICD-10-CM H47. A type 1 excludes note is a pure excludes. A 64-year-old white male presents for cataract surgery evaluation with best-corrected visual acuity of 20/60 OD and 20/40 OS. Full-Field ERG E. Draft article posted on 01/14/2021. I measured contrast sensitivity and glare in 51 cataract patients who had Snellen visual acuities of 20/60 or better. Cigarette smoking. Study Spring 2012 Dis Exam 5 (Last Material for final) flashcards. This study explores stroke risk factors and clinical variables that may assist in this differentiation. Mature cataract with white, liquefied cortex. 3 OS Periphery: OD: lattice, pigmented sup. A loss of vision (or an increased loss in vision) Vision that only occurs in one of your eyes (this is technically known as monocular diplopia) Glare from the sun or from. 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. Back of the eye . Nuclear cataracts are graded according to their color and opacification using slit lamp examination. White matter (neuronal axons coated in myelin) is located below the cortex and makes up the "subcortical" regions of the brain. 0. OBJECTIVES—To analyse the clinical features induced by lenticular infarction found in 20 patients, and to analyse the radiological and clinical correlations. H25. CII. What is a nuclear sclerotic cataract? How will it present?. Where the ICR/f rat has proved to be very useful is in imaging mass spectrometry of the lens proteins during aging [7], a study funded by NEI R21 EY020963. what type of shift does a cortical spoking cataract cause? hyperopic. 013 in processing claims, check the following: — See. 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. Nuclear Sclerotic Cataracts. Created for people with ongoing healthcare needs but benefits everyone. Yes: Therre are three areas of the lens that mau be affected by acquired cataract: the nucleus, the cortex and the posterior subcapsular region. Anterior segment exam revealed a moderate nuclear sclerotic and cortical spoking cataract OD and an early nuclear sclerotic cataract OS. 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. Discover the truth about whether you really need cataract surgery. An ocular health evaluation revealed early nuclear sclerosis and cortical spoking O. 0):. 1. Explanation: "Cortical Cataracts. Participants were included if they had normal age-related lens changes. "Cortical" refers to white opacities, or cloudy areas, that develop in the lens cortex, which is the peripheral (outside) edge of the lens. With the Lumera, a clearer view of the anterior capsule and red reflex enables me to complete the capsulorrhexis without difficulty (Figure 4). . External examination of OD disclosed slate-blue scleral pigmentation and dark brown iris with velvety surface consistent with ocular melanocytosis (Figure 1). Vacuoles. H25. 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. C, Horizontal optical coherence tomography (OCT) showing retinoschisis extending into the optic nerve. nuclear cataract is cloudiness in the "core" of your lens. Refer to NCCI and OPPS requirements prior to billing Medicare. Central corneal thickness with ultrasound pachymetry measured 552μm and 549μm. board-certified doctor by text or video anytime, anywhere. The phakic IOL is well positioned but may exhibit slight temporal displacement. The 2024 edition of ICD-10-CM H25. METHODS—Eight women and 12 men, mean age 73 years, were included in this study, which was carried out from 1 January 1994 to 30 November 1996. 35 - other international versions of ICD-10 Z68. Understand…Study with Quizlet and memorize flashcards containing terms like A & O (AAOx3), A/P, AAO and more. Dark/hypoechoic texture is usually better. Thus white for bone or stone. . The white lines in B represent a transparent region that is superficial to the opaque region. 3: Cortical spoking cataracts Sign in. Eyes were graded on a scale of 0 to 4. 59% APY 6 & 18-Month Jumbo (Nationwide) AEA Federal Credit Union CD Promotion: 3. 01) H25. 2 OD, 0. Study with Quizlet and memorize flashcards containing terms like nuclear sclerotic cataract, Blue Scleras, Episcleritis Connective tissue disease Wind, dust, chemicals, sun and more. The remainder of the examination is normal. 85mm OS: 32. Fig. A corresponding procedure code must accompany a Z. R3. Introduction. YAG. There are three different kinds of cataracts: nuclear sclerosis, cortical spoking and posterior. white and quiet. No phacodonesis is evident. The optometrist diagnoses the. 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. Diagnosis: Cuneiform Cataract: Comment to photo: Peripheral, wedge-shaped cortical opacities and nucleosklerosis nasally inferior. Doctors will also check for three primary forms of cataracts. Our ASC does a lot of cataract surgeries. Central serous (chorio) retinopathy. People with nuclear sclerosis often describe having a "filmy" sensation in their vision as if looking through a dirty window. Various types: Spokes and vacuoles. 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. 011 - other international versions of ICD-10 H26. ICD-10 code H25. H25. Funduscopically, diffuse, dark brown.