Bilateral cataracts as the presenting feature of type 1 diabetes in an 11-year-old girl

Abstract

Paediatric cataracts can present a diagnostic dilemma to ophthalmologists. Next-generation DNA sequencing (NGS) has been promoted as a tool to expedite the diagnosis of an underlying cause in such cases. The authors present an unusual case of bilateral cataracts in an 11-year-old girl as the first presenting feature of new type 1 diabetes mellitus. Prompt diagnosis and subsequent management of this potentially life-threatening condition were achieved through careful history taking and targeted biochemical testing. The authors feel this case highlights the significance of simple measures such as thorough history taking in the assessment of paediatric cataracts. It is important that these skills are not lost through the availability of clinical tools such as NGS.

Cataract in children and adolescents with type 1 diabetes. Insights from the German/Austrian DPV registry

“…Early cataract was described as a rare ocular complication in pediatric patients at diabetes onset by a series of case reports and single center studies 11–18 . Simunovic et al reviewed the literature and found 16 publications describing 74 pediatric patients with cataract.…”

“…6 Early cataract was described as a rare ocular complication in pediatric patients at diabetes onset by a series of case reports and single center studies. [11][12][13][14][15][16][17][18] Simunovic et al reviewed the literature and found 16 publications describing 74 pediatric patients with cataract. These publications suggest that female gender, adolescent age, a long history of hyperglycemic symptoms, and a high HbA1c at diabetes diagnosis are risk factors for cataract development, while the rate of ketoacidosis at diabetes onset seems to be lower in these patients.…”

“…15, > 15 years). A second approach was implemented using a failure plot (inverse survival) with all individuals with T1D (at risk) and subjects who developed a cataract, showing the risk for developing a cataract by diabetes duration.…”