Case Reports

Unusual optical findings in a young myopic patient with incipient nuclear sclerosis cataract

Case Report Details

First Author: E.Bettach ISRAEL

Co Author(s):    A. Shoshani   D. Zadok   A. Abulafia   Y. Weill   D. Smadja        

Abstract Details

Purpose:

To describe a significant myopic shift and the exact optical changes and aberrations of the lens in a case of NS Cataract.

Setting:

Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel. iSEARCH, Innovation Shaarezedek Eye Advanced Research Center Hub, Jerusalem, Israel

Report of Case:

A 38-year-old male was referred for consultation due to decreased visual acuity in his right eye. Past ocular history included high myopia and spectacle/contact lens wear for all vision tasks. On examination, best corrected visual acuity was 20/70 and 20/20 with a manifest refraction of -12.00\-3.00X90 and -8.25\-2.75X83 in the right eye and the left eye, respectively. Intraocular pressure was 13mmHg in both eyes. Anterior and posterior segment examination were normal and only mild incipient NS cataract was observed. Macular OCT was normal and corneal topography showed regular against the rule astigmatism of 1.4 diopters in both eyes. Biometry demonstrated similar axial length's and no sign of amblyopia. On Optical Path Difference Analyzer (NIDEK OPD III, Japan) a central focal increase in internal (lens) refractive power of -16 diopters was clearly observed with an increase in negative spherical aberration of -0.763 (-0.030 of the fellow eye). These significant refractive changes were overlooked due to the paucity of cataract changes. Cataract extraction was performed with excellent visual results.

Conclusion/Take Home Message:

The crystalline lens can be a source of significant optical changes even when there are no significant signs in clinical examination. Hence, it is advisable to obtain internal aberrometry scan prior to performing cornea or lens based refractive surgery.

Financial Disclosure:

None