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Photo Essay
February 1999

Type I Diabetic Cataract

Arch Ophthalmol. 1999;117(2):284-285. doi:10.1001/archopht.117.2.284

A 15-YEAR-OLD white girl complained of blurred vision and was found to have cortical cataracts and a fasting blood glucose level of 25 mmol/L (450 mg/dL). During the course of insulin regulation, the cataract in the right eye rapidly matured, resulting in a visual acuity decrease from 20/30 to 20/400 and a myopic shift from −4.00 to −7.00. Slitlamp examination of the right eye showed the lens to be markedly swollen with dense cortical opacities consisting of water clefts, vacuoles, and liquefied lens fibers (Figure 1). In the left eye, there was early cortical clouding, water clefts, vacuoles, and spokes (Figure 2). Zeiss-Scheimpflug imaging (Figure 3) demonstrated the shallow anterior chamber in the right eye (1.4 mm compared with a normal measurement of 2.7 mm), as well as the swollen lens, opaque cortex, and relatively clear nucleus. The left eye showed the early cortical cataract and clear nucleus. Eventually, the left cataract also became mature. The patient underwent successful cataract/intraocular lens surgery, with resulting visual acuity of 20/20 OU.

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