A 65-year-old diabetic man develops a rapidly progressive cataract with white flaky opacities in the anterior subcapsular region, associated with a sudden hyperopic shift. Which type of cataract is this?
- A Snowflake (metabolic) diabetic cataract ✓
- B Nuclear sclerotic cataract
- C Posterior subcapsular cataract
- D Lamellar (zonular) cataract
Correct answer: A. Snowflake (metabolic) diabetic cataract
Explanation
The snowflake cataract (true diabetic cataract) occurs in uncontrolled diabetes due to osmotic swelling of the lens from sorbitol accumulation via the polyol pathway. It presents with white, flaky, anterior and posterior subcapsular opacities and can progress rapidly in young diabetics. Nuclear sclerotic cataract (the more common form in older diabetics) causes a myopic shift, not hyperopic; the snowflake variety may cause a hyperopic shift as the lens dehydrates.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.