Metabolic cataracts in newly diagnosed diabetes

Abstract

The morphologically distinct diabetic or 'metabolic' cataract is rare in newly diagnosed insulin dependent diabetes. The cases described are of five adolescents (three girls, two boys) with newly diagnosed insulin dependent diabetes who developed metabolic cataracts close to the time of diagnosis (0-16 months). They all had a prolonged duration of symptoms before diagnosis (4-24 months) and high glycated haemoglobin levels at diagnosis (15-21%). The pathogenesis of diabetic cataract is not well understood in humans. An attempt is made to link clinical observations with evidence from experimental animal models to understand the mechanism of cataract formation, with particular reference to the aldose reductase pathway. It is recommended that the lens and retina are examined at the onset of diabetes in all children, especially those who have a prolonged duration of symptoms before diagnosis and who report persistent blurred vision.

Acute irreversible diabetic cataract in adolescence: a case report

“…1 In all, 25% of patients have cerebrospinal fluid displacement into the spinal cord canal, causing syringomyelia. 1,2 Familial clustering of CMI with and without syringomyelia has been documented in American scientific literature but this case of siblings appears to be the first instance reported in the UK.…”

“…1,2 It can affect visual acuity from slight visual impairment to complete blindness. 1 We report a case of acute bilateral irreversible metabolic cataract in a patient with recently diagnosed Type 1 diabetes mellitus.…”

Bilateral Early Cataracts in Type 1 Diabetes

“…Despite a reported higher incidence of Type-1 diabetes in male patients in most studies, most series have found a female preponderance for diabetic cataract, the reason for which is not clear [5]. In the cohort of Dutta et al [2], three of five patients with Type I diabetes who developed cataracts close to the diagnosis of diabetes were female. All had a prolonged duration of symptoms and high HbA1c .…”

“…Cataracts occur earlier in life and progress more rapidly in the presence of diabetes. Diabetic or metabolic cataracts are characterized by diffuse posterior and /or anterior, subcapsular or cortical 'snowflake' opacities [2].This is followed by appearance of more diffuse cloudiness and opacification.…”

“…There are a small number of reports of bilateral cataracts developing soon after diagnosis of diabetes [2][3][4][5][6][7][8].…”