Diabetes-related Cataracts

Overview of Diabetes-related Cataracts

A cataract is a clouding of the lens resulting in reduced vision. Cataract surgery restores vision and is the most common and successful ophthalmic surgery in the world. Due to increasing numbers of people living with type 1 and type 2 diabetes worldwide, the incidence of cataracts associated with diabetes is steadily rising. Mechanisms to delay or prevent the development of cataract in this population remains a challenge. Furthermore, people living with diabetes have higher complication rates from cataract surgery. Both diabetes and cataract pose an enormous health and economic burden, particularly in developing countries, where diabetes treatment is insufficient and cataract surgery often inaccessible 11.

Types of Cataract

Nuclear sclerotic cataract: The most common type of cataract. The centre portion of the natural lens of the eye – the nucleus – becomes yellow and hardens. ‘Sclerosis’ refers to the hardening of the lens nucleus. Deterioration of vision is usually gradual.

Cortical cataract: A less common form of cataract that appears as a cloudy opacity in the cortex, the outer part of the lens. The cataract resembles spokes that point inwards on the centre of the lens, causing light rays to hit the retina in a scattered fashion. With this type of cataract, the most frequent symptom is experiencing problems with glare.

Posterior subcapsular cataract: These cataracts form as opacities (opaque or cloudy area) on the back surface of the lens. It is called “subcapsular” because it forms beneath the lens capsule, which is a small “sac,” or membrane, that encloses the lens and holds it in place. They cause light sensitivity, problems with reading vision and glare. They are more prevalent among people living with diabetes and those who have taken corticosteroids over a period of time.

Diabetes-related “snowflake” cataract: These cataracts appear as grey-white subcapsular opacities and often progress rapidly turning the entire lens white. This rapid onset form of cataract is quite uncommon and may be found in some younger people living with type 1 diabetes with very elevated blood sugars.

 

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