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All Journal Indonesian Journal of Case Reports Grimsa Journal of Science Engineering and Technology
Navneet Shamsundar Toshniwal
Navneet Hospital, Solapur, Maharashtra, India
Agriculture, Biological Sciences & Forestry Chemical Engineering, Chemistry & Bioengineering Engineering Health Professions Medicine & Pharmacology Neuroscience Physics Public Health

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Delayed Bilateral Congenital Cataract with Asymmetric Morphology (Membranous and Nuclear) Managed with Different Surgical Techniques in a 19-Year-Old Female: A Case Report Eva Imelda; Sarra Mutiara Adev; Navneet Shamsundar Toshniwal
Indonesian Journal of Case Reports Vol. 4 No. 1 (2026): June 2026
Publisher : Heca Sentra Analitika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.60084/ijcr.v4i1.420

Abstract

Congenital cataract is a major cause of preventable childhood blindness, and delayed treatment may lead to irreversible amblyopia and complex lens degeneration. We report a 19-year-old female with long-standing bilateral congenital cataract and marked intra-individual asymmetry. The left eye (OS) had absolute sensory deprivation since infancy, while the right eye (OD) retained partial vision until late adolescence. Examination showed alternating exotropia of 45 prism diopters and intraocular pressures of 18 mmHg OD and 27 mmHg OS. The elevated OS pressure, attributed to secondary lens-induced angle crowding, was controlled to 19 mmHg with topical timolol 0.5%. B-scan ultrasonography confirmed flat, intact retinas and normal optic disc excavation bilaterally. Using SRK/T biometry, staged bilateral cataract surgery was performed under general anesthesia one month apart. OS showed a fully resorbed membranous cataract and required manual irrigation–aspiration with a Simcoe cannula, micro-scissor membranectomy, automated anterior vitrectomy, and sulcus-fixated IOL implantation (20.0 D). OD showed a mature nuclear cataract and was managed with phacoemulsification-assisted irrigation–aspiration and in-the-bag single-piece IOL implantation (22.50 D). Postoperatively, both eyes achieved a clear visual axis and stable IOL position without early complications. At 6 months, IOP remained stable (14 mmHg OD, 15 mmHg OS), with healthy pink optic discs. Corrected visual acuity reached 6/6 OD but remained 2/60 OS due to irreversible deprivation amblyopia. Delayed congenital cataract surgery in adulthood requires morphology-based planning. Nuclear cataracts may be safely treated with phacoemulsification, whereas membranous cataracts require meticulous manual extraction and anterior vitrectomy. Early red-reflex screening remains essential.
Beyond Hyperglycemia: Bilateral Total Cataract in an Adolescent with Type 1 Diabetes Mellitus Eva Imelda; Sarra Mutiara Adev; Navneet Shamsundar Toshniwal
Grimsa Journal of Science Engineering and Technology Vol. 4 No. 2 (2026): October 2026
Publisher : Graha Primera Saintifika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61975/gjset.v4i2.144

Abstract

Cataracts in children and adolescents with type 1 diabetes mellitus (T1DM) are uncommon but can cause profound visual impairment. This case report describes the clinical presentation, surgical management, and short-term outcomes of bilateral total cataracts in a 16-year-old female with an approximately two-year history of T1DM. Clinical data were retrospectively obtained from medical records, including ophthalmologic examinations, ocular biometry, operative reports, and postoperative assessments. At presentation, visual acuity was limited to hand movements in both eyes, and dense lens opacities prevented fundus visualization. The patient underwent sequential bilateral cataract extraction with posterior chamber intraocular lens implantation under general anesthesia. Uncorrected visual acuity improved to 6/6 in each eye during the first postoperative week and remained 6/6 at the one-month follow-up for each eye. This case highlights the potential for substantial visual recovery following surgery in an adolescent with bilateral total cataracts and T1DM. Although diabetes may have contributed to cataract formation, the available clinical information does not establish a causal relationship. Continued diabetes management and individualized ophthalmic follow-up remain important for long-term ocular health.
Co-Authors Eva Imelda Sarra Mutiara Adev