Diabetes mellitus is a significant risk factor for the development of cataracts, the second most common ocular complication in this patient population. Various visual disturbances may be noted in diabetic cataract, and the diagnosis requires a slit-lamp examination.
Cataracts are considered to be one of the earliest complications of diabetes mellitus, and they are confirmed as the most common cause of visual impairment in older age diabetics  . Some studies report that female patients are more likely to develop a cataract, but the observed gender predilection is yet to be confirmed . Other studies, however, report that poor glycemic control greatly contributes to the development of cataracts, particularly ketoacidosis, which can directly promote corneal damage by reducing the number of viable antioxidant molecules . Compared to classical senile cataracts that have a slow development over a period of years , diabetic forms seem to have an earlier onset and a more progressive clinical course , with most important features being the development of posterior, anterior, subcapsular or cortical opacities of the cornea . These pathological changes can affect only one eye, but cases of bilateral diabetic cataracts have been documented . Loss of contrast, a necessity for more illumination to maintain adequate vision, issues with distinguishing dark blue from black color, as well as halos around lights, are most common complaints . In severe cases, painless blurring and severe vision impairment can occur, and it is not uncommon for cataracts to cause blindness   . Swelling of the cataract may occur in rare cases and cause pain provoked by secondary closed-angle glaucoma, due to mechanical compression of the iris and the trabecular meshwork .
- Corneal Edema
PURPOSE: To compare levels of selected mediators in serums and aqueous humor (AH) of type 2 diabetes mellitus cataract patients with senile cataract patients, and to determine their association with postoperative corneal edema (CE). [ncbi.nlm.nih.gov]
Particularly, investigators focused on the development of corneal edema as one of the main causes of low visual acuity in the immediate postoperative period after intraocular lens implantation. [clinicaltrials.gov]
On the first day postoperatively, diffuse corneal edema occurred with Descemet membrane striae, and the corneal epithelium detached on a large scale. Within 2 weeks, the cornea was clear with adherent epithelium and smooth Descemet membrane. [journals.lww.com]
Eye. 1992; 6: 296–299 Crossref PubMed Scopus (13) Google ScholarSee all References In NVG presenting acutely with pain, corneal edema, and moderate cataract, medications and serial paracenteses may provide media clearing sufficient for PRP. [aaojournal.org]
- Corneal Opacity
[…] lens cloudiness or opacity corneal opacity retinal opacity Answer: A What is the symptom of cataract? pain blurring of vision squint Answer: B How do we treat cataract? surgery taking medication taking herbs Answer: A [pendidikanpesakit.myhealth.gov.my]
E11.39 Type 2 diabetes mellitus with other diabetic ophthalmic complication E11.4 Type 2 diabetes mellitus with neurological complications E11.40 Type 2 diabetes mellitus with diabetic neuropathy, unspecified E11.41 Type 2 diabetes mellitus with diabetic mononeuropathy [icd10data.com]
Cataracts can be confirmed by a slit-lamp examination that will identify yellow, gray or white opacities in the lens . Other signs may include recurrent corneal erosions and ulcerations, increased autofluorescence and reduced corneal sensitivity, while the examination of the red reflex at a distance of around 30 cm from the affected eye through the use of an ophthalmoscope will confirm the presence of corneal opacities  . Pupillary dilation before the eye examination is advocated, to obtain a better view of the entire apparatus and possibly detect other pathological changes, such as diabetic retinopathy . Assessment of visual acuity, gonioscopy, funduscopy, and tonometry are other tests that can be employed, so that the exact type and location of the cataract may be determined . In addition to physical examination, a detailed laboratory workup should be carried out in all patients with an undisclosed cause of cataract development, comprising serum glucose levels and hemoglobin A1C (HbA1c). Obtaining a proper family history that will potentially determine the presence of diabetes mellitus within the family or close relatives is also an important step when assessing patients with cataracts. Moreover, patients should be asked whether they exhibit some of the more common symptoms of diabetes (polyuria, polydipsia or polyphagia), the primary reason being the detection of diabetes.
Four of the six patients had at least a six-month history of diabetic symptoms before the treatment was started, and five patients had ketoacidosis at initial admission to hospital. [ncbi.nlm.nih.gov]
References Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. [care.diabetesjournals.org]
Over three years, the team at CERA tested and compared two treatments injected into the eye of patients with DME undergoing cataract surgery. [cera.org.au]
Aggressive treatment of neovascular glaucoma must take priority over cataract treatment because the prolonged increase in IOP can cause permanent damage to the optic nerves and severe visual loss. [healio.com]
EUROTIMES STORIES Evolution of cataract surgery and management of diabetic retinopathy has resulted in improvement of prognosis following cataract surgery in diabetic patients. [eurotimesindia.org]
[…] non-steroidal anti-inflammatory drugs in addition to routine topical steroid preparations, particularly in those with pre-existing macular oedema. 3 In summary, diabetes patients with mild to moderate diabetic retinopathy and no maculopathy have a good prognosis [cehjournal.org]
In general, the visual prognosis following cataract surgery in diabetic patients is favorable. [ncbi.nlm.nih.gov]
What's the prognosis for a person with diabetic eye disease? The earlier diabetic eye disease is diagnosed and treated (if necessary), the better the prognosis. [emedicinehealth.com]
Abstract Aldose reductase (AR) has been implicated in the etiology of diabetic cataract, as well as in other complications. [ncbi.nlm.nih.gov]
Keywords: Diabetes mellitus/complications; Cataract/etiology; Hyperopia; Case reports [Publication type] RESUMO Paciente de 13 anos, com história recente de hiperglicemia, desenvolveu subitamente, catarata subcapsular posterior em ambos os olhos, consistindo [scielo.br]
Ophthalmology 108 : 1767 –1776, 2001 Chen CS, Miller NR: Ocular ischemic syndrome: review of clinical presentations, etiology, investigation, and management. [care.diabetesjournals.org]
Information on possible benefits of putative anticataract agents comes from a variety of approaches, ranging from laboratory experiments, both in vitro and in vivo, to epidemiological studies in patients. [ncbi.nlm.nih.gov]
There is few recent cataract epidemiology study which focus on diabetic population especially in developed countries. [discovery.dundee.ac.uk]
The “Wisconsin Epidemiologic Study of Diabetes-related Retinopathy” investigated the incidence of cataract extraction in people with diabetes. [retina-ded.org]
Epidemiology of diabetic retinopathy. In; Management of diabetic retinopathy. London: BMJ Publishing Group; 1996. p. 1-15. 4. Kokiwar PR, Gupta S, Durge PM. Prevalence of diabetes in a rural area of central India. [meajo.org]
Many epidemiological and clinical studies documented the higher prevalence of cataract in diabetic patients [14, 15]. [go.galegroup.com]
It is the first report of inhibition interaction between AR and iNOS, suggesting a new pathophysiological mechanism and providing a new insight into the therapeutic mechanism of DC. Copyright 2017 Elsevier Inc. All rights reserved. [ncbi.nlm.nih.gov]
Pathophysiology of the immune system in elderly subjects with or without diabetes and variations after recombinant interleukin-2. Arch Gerontol Geriatr 1989;9:163-80. 27. [egyptretinaj.com]
[…] diabetes was associated with a substantial reduction in the long-term risk of ocular surgery.11 A systematic review and meta-analysis have shown that treatment with IIT for two to three weeks can induce a glycaemic remission and can improve the underlying pathophysiology [academic.oup.com]
All the findings above provide encouraging evidence for emodin as a potential therapeutic agent to prevent cataract in diabetic patients. [ncbi.nlm.nih.gov]
A good diabetic control is also good to prevent diabetic retinopathy progression which is one of the commonest causes of blindness. [pendidikanpesakit.myhealth.gov.my]
- Onakpoya OH, Bekibele CO, Adegbehingbe SA. Cataract surgical outcomes in diabetic patients: case control study. Middle East Afr J Ophthalmol. 2009;16(2):88.
- Javadi MA, Zarei-Ghanavati S. Cataracts in Diabetic Patients: A Review Article. J Ophthalmic Vis Res. 2008;3(1):52-65.
- Pakhetra R, Jyotsna V. Bilateral Early Cataracts in Type 1 Diabetes. Med J Armed Forces India. 2009;65(1):71-72.
- Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011.
- Pollreisz A, Schmidt-Erfurth U. Diabetic Cataract—Pathogenesis, Epidemiology and Treatment. J Ophthalmol. 2010;2010:608751.