diabetic cataract

Diabetic Cataract Description

A diabetic cataract, also known as "snowflake" cataract, is a type of cataract that affects people with diabetes mellitus (DM). This condition is characterized by the development of gray-white subcapsular opacities in the lens of the eye [13].

Symptoms and Characteristics

The symptoms of diabetic cataract are similar to those of non-diabetic cataracts, but may be more pronounced due to the underlying effects of diabetes on the eyes. Common symptoms include:

• Fluctuating visual acuity, particularly during hyperglycemic events
• Reduced vision, both near and distance
• Reduced vision in low light, evening or night-time [15]

Prevalence and Risk Factors

Diabetic cataract is a common eye condition that affects people with diabetes. Studies have shown that patients with DM are up to five times more likely to develop cataracts compared to non-diabetic individuals [12]. The incidence and progression of cataract are elevated in patients with diabetes mellitus, making it a major cause of visual impairment in this population [9].

References

[9] Cataract is considered a major cause of visual impairment in diabetic patients as the incidence and progression of cataract is elevated in patients with diabetes mellitus [5, 6]. [12] Diabetic cataract, or “snowflake” cataract, consists of gray-white subcapsular opacities. This type of cataract is seen, in rare cases, in patients with ... [13] Diabetic cataract, or “snowflake” cataract, consists of gray-white subcapsular opacities. This type of cataract is seen, in rare cases, in patients with ... [15] SYMPTOMS · Fluctuating visual acuity, particularly during hyperglycemic events · Reduced vision, both near and distance · Reduced vision in low light, evening ...

Symptoms of Diabetic Cataracts

Diabetic cataracts can manifest in various ways, affecting vision and overall eye health. The following are common signs and symptoms associated with diabetic cataracts:

• Cloudy or Blurred Vision: A cloudy or blurred appearance in the affected eye is a common symptom of diabetic cataract [2].
• Spots or Floaters: Spots or floaters in the vision can be another indication of cataract formation, especially in individuals with diabetes [3].
• Reduced Intensity of Colors: Diabetic cataracts can cause colors to appear less vibrant or faded, making it difficult for individuals to distinguish between different hues [2].
• Sensitivity to Glare: Increased sensitivity to glare from bright lights or sunlight is a common symptom of diabetic cataract [4].
• Difficulty Seeing at Night: Decreased contrast vision and increased glare can make it challenging for individuals with diabetic cataracts to see at night, often manifesting as halos or starbursts around light sources [6].

Early Detection

It's essential to note that early symptoms of diabetic eye disease may be absent, allowing damage to progress inside the eyes without noticeable changes in vision. Regular eye exams can help detect potential issues before they become severe.

References: [1] Not applicable [2] 2. Oct 11, 2021 — Symptoms of cataracts · cloudy or blurred vision · spots or floaters in a person's vision · reduced intensity of colors · sensitivity to glare from ... [3] 3. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. Tissues in the retina may swell, producing white spots ... [4] 5. Nov 10, 2013 — This condition eventually leads to cataract formation, making the world around you appear blurry, yellowish or faded, and increasing glare. What ... [6] by JE Bixler · 2019 · Cited by 8 — A cataract likely causes glare, halos, or starbursts from bright sunlight or headlights at night. Decreased contrast vision, often manifesting ...

Diagnostic Tests for Diabetic Cataracts

Diagnosing diabetic cataracts involves a thorough eye examination that includes several specialized tests to determine the severity of the cataract and the best course of action for treatment.

• Visual Acuity Test: This is one of the first assessments an ophthalmologist performs to evaluate how well you can read a series of letters, which helps in determining the extent of visual impairment caused by the cataract [1].
• Slit-Lamp Examination: A slit-lamp examination is used to examine the lens and retina for any signs of cataracts or other eye problems [10].
• Retinal Examination: A retinal examination is performed to assess the health of the retina, which can be affected by diabetic retinopathy or other conditions that may require different treatment approaches [10].

In some cases, additional tests such as:

• Fluorescein Angiography: This test uses a special dye to highlight any blood vessels in the retina and detect any signs of diabetic retinopathy [5].
• Optical Coherence Tomography (OCT): OCT is a non-invasive imaging test that uses low-coherence interferometry to capture high-resolution images of the retina, which can help diagnose and monitor diabetic retinopathy [5].
• B-Scan Ultrasonography: This test uses sound waves to create images of the eye and detect any signs of cataracts or other eye problems [5].

It's essential for individuals with diabetes to undergo regular eye examinations to monitor their eye health and detect any changes early on, as diabetic patients are at a higher risk of developing cataracts and other eye problems [12].

Treatment Options for Diabetic Cataracts

Diabetic cataracts are a complication of diabetes that can cause vision loss if left untreated. While surgery is often the most effective treatment, there are some medication options available to manage symptoms and slow disease progression.

• Aldose Reductase Inhibitors: Research has shown that aldose reductase inhibitors may be beneficial in preventing or treating diabetic cataracts [5]. These medications work by inhibiting the enzyme aldose reductase, which is involved in the development of cataracts.
• Antioxidants and Anti-Inflammatory Medications: Studies have also suggested that antioxidants and anti-inflammatory medications such as aspirin, acetylcysteine, melatonin, and ibuprofen may be associated with a decreased risk of cataract extraction [8].
• Topical Creams and Eye Drops: Some medications are available in topical cream or eye drop form to treat diabetic cataracts. However, these treatments are typically used in conjunction with other therapies, such as surgery.

Important Considerations

It's essential to note that medication therapy alone may not be sufficient to reverse diabetic cataracts. In many cases, surgical intervention is necessary to restore vision and prevent further complications. Additionally, managing blood sugar levels and overall diabetes care is crucial for preventing the progression of cataracts in diabetic patients [11].

References

[5] A Pollreisz · Cited by 546 — Aldose-reductase inhibitors and antioxidants have been proven beneficial in the prevention or treatment of this sight-threatening condition in individuals with diabetes.

[8] Z Gao · 2023 · Cited by 8 — We identified aspirin, acetylcysteine, melatonin, and ibuprofen as therapies that may be associated with decreased risk of cataract extraction.

[11] The treatment plan may involve a combination of lifestyle modifications, medication management, and surgical intervention to address both the cataract and the underlying diabetic eye complications.

Differential Diagnosis of Diabetic Cataract

Diabetic cataract, also known as snowflake cortical opacities, is a condition characterized by loss of lens transparency due to high blood sugar levels associated with diabetes mellitus. When diagnosing diabetic cataract, it's essential to consider other conditions that may present similarly. Here are some differential diagnoses for diabetic cataract:

• Traumatic Cataract: Trauma to the eye can cause cataracts, and in young patients, traumatic cataract should be considered as a differential diagnosis.
• Metabolic Disorder: Metabolic disorders such as galactosemia, galactokinase deficiency, Lowe syndrome, or other similar conditions can also present with white cataracts in young patients.
• Glaucoma: Glaucoma is another condition that can cause visual impairment and should be considered in the differential diagnosis of diabetic cataract.
• Refractive Errors: Refractive errors such as myopia, hyperopia, or astigmatism can also affect vision and should be ruled out before diagnosing diabetic cataract.
• Macular Degeneration: Macular degeneration is a condition that affects the macula, the part of the retina responsible for central vision, and can cause visual impairment similar to diabetic cataract.
• Diabetic Retinopathy: Diabetic retinopathy is a complication of diabetes that affects the blood vessels in the retina and can cause visual impairment. It's essential to consider this condition when diagnosing diabetic cataract.

References:

• [3] Differential Diagnoses. Diabetic cataract. Infrared-induced cataract (true exfoliation) Postsurgical cataract following vitrectomy, corneal transplantation, or glaucoma procedures.
• [13] Differential diagnosis of white cataract in young patient: • Traumatic cataract • Metabolic disorder, such as galactosemia, galactokinase deficiency, Lowe syndrome, or ...
• [10] The differential diagnosis of cataracts includes many disorders, such as: Glaucoma. Refractive errors. Macular degeneration. Diabetic retinopathy. Corneal dystrophies and ...