Lenticular progressive myopia in a young male patient

Abstract

Cataracts often develop as part of the natural aging process. Nuclear sclerosis, a type of cataract causes the core of the lens to harden which ultimately increases the lens refractive power and causes nearsightedness. Although myopia is associated with nuclear sclerosis, this finding is not common among young individuals less than 40 years. The purpose of the study is to report a case of visual disabling nuclear cataract in a young myopic male who was previously diagnosed as being amblyopic in his left eye following visits to several physicians. A 35-year-old public service male worker presented to us with history of painless progressive diminution of vision in his left eye of five years duration. We performed a detailed ocular examination which showed an unaided distant vision right eye (RE)- 20/200; and the left eye (LE) - 20/400. His aided Vision (spectacles) RE: 20/20; LE: 20/160. An anterior segment examination using the slit lamp biomicroscope was normal except for the lens which showed nuclear sclerosis grade 1+ in the right eye and grade3+ in his left eye. The fundus examination was normal. A Swept Source Anterior Segment Optical Coherence Tomography (OCT) and Itrace ray tracing aberrometer assessed the density of the nucleus opacity and degree of internal aberrations induced by the nuclear sclerotic cataract respectively. He subsequently had a phacoemulsification surgery with an extended depth of focus non-toric intraocular lens implantation (EDOF-non-toric IOL) and attained a best corrected visual acuity (BCVA) of 20/20 in his left eye. Cataract extraction is therapeutic in young myopes with visually disabling nuclear sclerosis and prompt diagnosis is important to avoid repeated visits to the ophthalmologist.