Ophthalmology · UKMLA & AKT
Diabetes-related cataract
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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