A 28-year-old man with tremors and personality change is found to have golden-brown disc-like opacities radiating from the centre of the lens towards the equator, located just beneath the anterior capsule. What is the underlying cause?
- A Deposition of copper in the anterior lens capsule and subcapsular region ✓
- B Accumulation of sorbitol within lens fibres
- C Iron overload in the lens epithelium
- D Calcium phosphate deposition beneath the capsule
Correct answer: A. Deposition of copper in the anterior lens capsule and subcapsular region
Explanation
The sunflower cataract of Wilson disease results from copper deposition in the anterior capsule and subcapsular zone, producing a disc with radiating petals resembling a sunflower. It does not significantly reduce vision. Sorbitol accumulation produces snowflake opacities in diabetes, iron causes siderosis with rust-coloured staining, and calcium phosphate is seen in hypoparathyroid cataracts, none of which produce this morphology.
Reference: Parsons' Diseases of the Eye, 23rd ed.
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Written and medically reviewed by the StethoPrep medical team.