The onset of cataract formation is normally experienced in senile age. The process of lens
opacification can also be influenced by other factors, including systemic diseases, infection, trauma,
medication, ultra violet light exposure, genetic predisposition and environmental sources. Gradual
vision loss accompanied by a myopic refractive shift can be caused by nuclear cataract formation,
even in young patients. Phacoemulsification cataract removal and intraocular lens insertion surgery is
indicated when visual acuity loss and/or myopic anisometropia becomes a problem. The case
reported here is of an early onset nuclear cataract in a young male. A 44-year-old man visited the
hospital complaining of gradual vision loss in his right eye. History study revealed no systemic or
ophthalmic diseases or trauma. The patient underwent phacoemulsification nuclear cataract removal
and intraocular lens insertion surgery in his right eye, followed by Nd:YAG laser posterior capsulotomy
3 years later. He underwent phacoemulsification nuclear cataract surgery in his left eye at the age of
48 years, followed by laser capsulotomy treatment 2 years later. At the age 50, a routine eye
examination revealed retinal detachment in his right eye. He underwent vitrectomy surgery twice.
Nuclear lens opacification is seldom of clinical importance in young healthy adult patients, however, it
can be the cause of progressive visual acuity loss, especially in the presence of a myopic refractive
shift. Nuclear cataract should be part of the differential diagnosis, even if signs are subclinical,
especially in the presence of a myopic refractive shift. This case shows that thorough and periodic
routine eye examinations are a must when dealing with patients with unexpected and atypical signs
and symptoms, especially having underwent surgery and laser treatments.
Author (s) Details
Marco Zeppieri
Department of Ophthalmology, University Hospital of Udine, Italy.
Carlo Salati
Department of Ophthalmology, University Hospital of Udine, Italy.
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