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Oil Droplet Cataract

  • Commonly seen in patients with galactosemia (a recessively inherited inborn error of carbohydrate metabolism).
  • Accumulation of dulcitol (galactose reduction product) within the lens cells leads to increased intracellular osmotic pressure and fluid influx into the lens.
  • Clinical features:
    • Symptoms: decreased vision depends on the severity of the cataract
    • Signs:
      • Bilateral lens changes
      • Zonular or nuclear opacity with increased refractive power of the nuclear portion causes an "oil droplet" appearance on retroillumination
      • Lenticular myopia
      • May progress to total opacification of the lens if the systemic condition is left untreated
  • Management:
    • Remove galactose from the diet
    • Avoid all milk products to prevent the progression of cataract and mental retardation.

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