J Korean Ophthalmol Soc.  2016 Jun;57(6):963-968. 10.3341/jkos.2016.57.6.963.

Oil Droplet Cataract: Cause of Decreased Vision of Unknown Etiology

• Lee HJ
• Kim JY
• Lee MW
• Lee YH

• KMID: 2290500
• DOI: http://doi.org/10.3341/jkos.2016.57.6.963

Abstract

PURPOSE
To report cases of oil droplet cataract, one cause of decreased vision of unknown etiology.
METHODS
We performed a retrospective chart review analysis of patients referred to the neuro-ophthalmology clinic due to unknown etiology of decreased visual acuity and diagnosed with oil droplet cataract. Clinical features including history, result of ophthalmologic examinations, and clinical course were evaluated.
RESULTS
Among the patients referred to the neuro-ophthalmology clinic due to unknown etiology of decreased visual acuity, 6 patients were diagnosed with oil droplet cataract. The patients ranged from 38 to 63 years of age and their best corrected visual acuities at their first visits were between 0.1 and 0.7. Ophthalmologic examinations including neuro-ophthalmologic tests were normal except for changes in lens nucleus and peculiar fundus reflexes were observed using retinoscopy in all patients. Five eyes of 4 patients underwent cataract surgery and all 5 eyes achieved the best corrected visual acuity of 1.0 or higher.
CONCLUSIONS
Oil droplet cataract is a cause of decreased visual acuity of unknown etiology that can be missed. The disease abnormalities are difficult to observe because only subtle changes in lens nucleus are apparent on slit lamp examination; however characteristic fundus reflexes can be identified using retinoscopy. Ophthalmologists should thoroughly understand the oil droplet cataract and diagnose it in the early stages to avoid misdiagnosis and unnecessary costs.

Keyword

Decreased vision of unknown etiology; Oil droplet cataract; Retinoscopy

MeSH Terms

Cataract*
Diagnostic Errors
Humans
Reflex
Retinoscopy
Retrospective Studies
Slit Lamp
Visual Acuity

Figure

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  Figure 1. Comparison of lens status between patients and normal controls. Slit lamp photographs (A) and scheimpflug image of the right eye in patient 1 (B). The center of nucleus is relatively homogeneously foggy compared to the fairly clear cortex. The average and maximal opacity of the lens were 8.7% and 11.8%. Pentacam nucleus staging was stage 2. In normal eye, the average and maximal opacity of lens were 0% (C). PNS =Pentacam Nucleus Staging; Std. Dev = standard deviation.

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  Figure 2. Fundus photography of patient 2. The left eye has oil droplet cataract. But the right eye has a clear lens. The view of the left fundus (B) is not hazy compared to the right fundus (A).

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  Figure 3. Comparison of fundus reflex between patients and normal controls. Retinoscopy can identify characteristic dark silluette (arrows) fundus reflexes (A) in contrast with normal reflex (B).

Reference

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