Spontaneous Resolution of a Rapidly Formed Dense Cataract Following Nd: YAG Laser Peripheral Iridotomy in a Case of Pigmentary Glaucoma

Spontaneous resolution of a unilateral cataract in an adult: A case report

RATIONALE

Cataracts are a disease that is usually caused by aging and involve the irreversible degeneration of the lens material. On the other hand, transient cataracts have also been reported, mainly due to systemic hyperglycemia, which often occurs bilaterally. However, reports of the spontaneous regression of unilaterally occurring cataracts in patients with normal blood glucose levels are rare. Here, we report a rare case of spontaneous regression of unilateral posterior subcapsular cataracts in an adult with normal blood glucose levels.

PATIENT CONCERNS

A 42-year-old woman presented with distorted vision in her right eye. The patient was taking medication for diabetes, and her blood sugar level was well-controlled.

DIAGNOSIS

Upon examination, her uncorrected visual acuity and best-corrected visual acuity were 20/70 in her right eye. Slit lamp microscopy revealed fine, feathery, and streak-like posterior subcapsular opacities. Color fundus photography revealed a star-shaped shadow due to the cataract, and no diabetic retinopathy was observed. Her two hour postprandial glucose level was 115 mg/dL. The patient was diagnosed with posterior subcapsular cataracts, and cataract surgery was planned. The patient was scheduled to visit the clinic again after seven days.

INTERVENTIONS

Close observation for one week without any intervention.

OUTCOMES

After one week, most of the posterior subcapsular opacities disappeared, and the uncorrected visual acuity and best-corrected visual acuity in the right eye improved to 20/40 and 20/30, respectively.

LESSONS

This case report demonstrates that unilateral posterior subcapsular cataracts may spontaneously regress in patients with normal blood glucose levels. Therefore, it is important to check whether cataracts improve spontaneously through short-term close follow-up before planning cataract surgery to avoid unnecessary surgery.

Spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury: a case report

Background

We report a case of spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury. This case highlights the importance of conservative management in these types of cases, as excellent visual outcome is possible without invasive surgical intervention.

Case presentation

A 13-year-old boy presented with a corneal laceration in the left eye caused by a neuter pen. He underwent emergency repair of the corneal laceration under general anesthesia, and at 3 days post-op, a dense posterior cortical cataract was observed. Based on the patient’s age and normal visual development, in addition to preserving accommodative potential, the patient received conservative management and follow-up. Interestingly, the cataract spontaneously resolved over the following 9 months and the corrected distance visual acuity in the injured eye was restored from finger counting at 50 cm, to 20/25 + 3.

Conclusions

To optimize treatment in pediatric traumatic cataract, several critical factors such as age, visual development and the preservation of accommodative potential, need to be comprehensively considered. Conservative management with lens preservation is important to consider in young, traumatic cataract patients where invasive surgical intervention may not be required.