Diagnosis and treatment of metabolic cataract

Abstract: metabolic cataract is commonly seen in diabetic cataracts, galactose cataract and tetanic cataract. What is the diagnosis and treatment of metabolic cataract? The following is explained by the small editor of jianke.com.

1. Diabetic cataract and diabetic cataract are caused by increased blood glucose, increased glucose in the crystalline form, transformed into sorbitol, increased osmotic pressure, water absorption by the body, and turbid degeneration of fibers. It can be divided into 2 types, one is the merger of senile cortical cataract, the other is true diabetic cataract.

1 The incidence of senile cataract is similar to that of senile cataract. Incidence rate is relatively high. It occurs earlier, develops faster and is more mature.     2. True diabetic cataracts are most common in adolescents with diabetes. Most of them are binocular diseases, which develop rapidly, and even develop into complete opacity of lens in a few days, weeks or months. At the beginning, typical white dot or snow flake opacity appeared under the anterior and posterior capsules, and rapidly expanded into complete cataract. It is often accompanied by refractive changes. When blood glucose increases, the content of inorganic salts in blood decreases, the osmotic pressure decreases, and aqueous humor infiltrates into the crystalline body, making it convex and forming myopia; When blood glucose decreases, water seeps out of the crystal body, and the product becomes flat to form hyperopia. Treatment 1 In the early stage of the disease, diabetes can be actively treated. Haze may be partially subsided and vision can be improved to varying degrees. Eye drops for cataract treatment.     2. When cataract affects eyesight, cataract extraction can be performed under the condition of blood glucose control, such as no proliferative diabetic retinopathy, and implantation of posterior chamber intraocular lens.     3. Infection and bleeding should be actively prevented after operation. Galactose cataract galactose cataract is caused by enzyme defects related to galactose metabolism. Such children lack galactose kinase or galactose-l-phosphate uridine transferase, so that galactose cannot be converted into glucose and accumulates in the body, so that galactose in aqueous humor infiltrates into the lens, and lens fiber edema forms turbidity. “Clinical manifestation” is an autosomal recessive disease, which can occur several days or weeks after birth, mostly lamellar cataract. Treatment: lactose free and galactose free diet.

III. tetany cataract is caused by low serum calcium. Most of them are due to accidental removal of parathyroid gland during thyroidectomy, or congenital deficiency of parathyroid function, or low blood calcium due to nutritional disorders, such as infants suffering from chondropathy or calcium deficiency during lactation. It is named because hypocalcemia patients often have tetany. Clinical manifestations 1 Have a history of thyroid surgery or nutritional disorders, low blood calcium and elevated blood phosphorus.     2. There were three typical changes: tetany, osteomalacia and cataract.     3. There is radial or stripe opacity in the anterior and posterior cortex of the lens of both eyes, which is separated from the capsule by a transparent band. Red, green or blue crystalline particles can be seen under the capsule. Turbidity can gradually develop into deep cortex, and severe cases can develop into complete turbidity in a short time. Infants and young children are mostly circumnuclear cataract. Treatment 1 Give sufficient vitamin D and calcium. Use parathyroid preparations when necessary, except for pseudoparathyroid insufficiency, which has normal parathyroid glands and induces similar clinical and blood changes due to renal insufficiency.     2. When cataract obviously affects vision, extracapsular cataract extraction can be performed, and blood calcium should be corrected before operation. Bleeding is easy during operation.

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