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 Opacity
[…] will confirm the presence of corneal opacities. [symptoma.com]
[…] 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]
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.
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]
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]
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]
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]
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]
Regardless of treatment, however, the vision prognosis of central RAO is poor ( 128 ). 4. [care.diabetesjournals.org]
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]
Many epidemiological and clinical studies documented the higher prevalence of cataract in diabetic patients [14, 15]. [go.galegroup.com]
Incidence of cataract surgery in the Wisconsin epidemiologic study of diabetic retinopathy. Am J Ophthalmol. 1995;119:295-300. West SK, Valmadrid CT. Epidemiology of risk factors for age-related cataract. Surv Ophthalmol. 1995;39:323-34. [ijmedicine.com]
Arch Ophthalmol 102:520–526 PubMed CrossRef Google Scholar Klein R, Klein BE, Moss SE et al (1984b) The Wisconsin epidemiologic study of diabetic retinopathy. III. [link.springer.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]
"The relationship of depression and diabetes: pathophysiological and treatment implications". Psychoneuroendocrinology. 36 (9): 1276–86. doi:10.1016/j.psyneuen.2011.03.005. PMID 21474250. ^ Li M, Fitzgerald P, Rodin G (April 2012). [en.wikipedia.org]
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]
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]
The severity of the cataract sometimes prevents adequate examination or treatment of the retina in patients with diagnosed or suspected severe non-proliferative and proliferative diabetic retinopathy. [cehjournal.org]
- 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.