Endocrine Abstracts

Introduction: Cataracts are an opacification of the crystalline lens, either partial or total, primarily caused by senescence, and rarely of metabolic origin. We present the case of a 24-year-old newly diagnosed with bilateral cataracts.

Case Presentation: E.S., a 24-year-old with newly discovered diabetes on insulin therapy, presented with a sudden and significant decrease in visual acuity. Ophthalmologic examination revealed bilateral cataracts with an inaccessible fundus. The patient was referred to us with an HBA1C of 13% for preoperative management.

Discussion: Diabetes is a metabolic disease that can have ophthalmic complications, particularly retinal and crystalline. Cataracts complicate diabetes in 8.8-22%. The pathophysiology of this cataract would be explained either by hyperglycemia leading to an elevation of glucose and its metabolites in the crystalline lens, the excess of intracellular glucose is unable to be metabolized by hexokinase, is converted into sorbitol and then into fructose. However, sorbitol and fructose do not cross the cell membrane, and accumulate, leading to intracellular hyperosmolarity or disruption of the function of the Na + K + ATPase pump, which can make the crystalline lens more sensitive to oxidative stress.

Conclusion: Cataracts are a rare complication of diabetes, especially in young people with newly diagnosed diabetes, which makes our observation unique.