Type 1 Diabetes & Cataracts

Question: I am Type 1 Diabetic and my Optometrist told me that I had the start of very small cataracts in 2008. I have not had any problems with them. At the start of July 2012 I noticed all of a sudden a small amount of fogginess at the top of my vision in my right eye. I went and saw my Ophthalmologist and after numerous tests he told me that the cataracts were minor and that he could not see anything wrong with my eye and to go and buy some eye drops. 5 weeks later the fogginess has become much worse and the vision in the entire eye is cloudy. I had a prescription check at the Optometrist as I thought maybe that could be the problem and she said that it could not be the cataract as it is so small and she did not know what the problem was. I then went back to the Ophthalmologist and he said that I needed to have cataract surgery and booked me in and took measurements etc. I asked him if he was sure it was the cataract as he said that it wasn't a problem 5 weeks ago. He said it had to be as it wasn't anything else. So I am just wondering if cataracts can develop this fast, from normal vision to very very cloudy in just 6 weeks? I am very scared of this surgery as I think the fogginess will still be there after the operation and maybe I have been misdiagnosed.


Answer: Cataracts are an extremely common eye problem associated with Diabetes. Data from the Framingham and other eye studies indicate a three to four fold increased prevalence of cataract in patients with diabetes under the age of 65, and up to a twofold excess prevalence in patients above 65. The risk is increased in patients with longer duration of diabetes and in those with poor metabolic control. A special type of cataract—known as snowflake cataract—is seen predominantly in young type 1 diabetic patients and tends to progress rapidly. Another type of cataract called a posterior sub capsular cataract is also extremely rapid in its progression and tends to locate along the visual axis which decreases vision quite rapidly.

That said, you must be certain that your blood glucose is stable and that there is no evidence of Diabetic Macular Edema which would also cause a variable and quick drop in vision. These are things in all likelihood your Cataract Surgeon considered and ruled out prior to making the final diagnosis.

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