Ophthalmology · UKMLA & AKT
Diabetes-related cataract
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise diabetes-related cataract — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- Hyperglycaemia saturates the polyol pathway → aldose reductase converts excess glucose to sorbitol → sorbitol accumulates in lens (cannot diffuse out) → osmotic water influx → crystallin protein disruption → lens opacity
- Advanced glycation end-products (AGEs) cross-link crystallins; oxidative stress compounds damage
- Transient myopic shift - acute hyperglycaemia causes osmotic lens swelling → increased refractive power → temporary short-sightedness; resolves with glycaemic control
Refraction should only be measured once glucose is well controlled - a myopic shift in a diabetic patient should prompt HbA1c check before prescribing new glasses.
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