Characteristic Cataract Associated with Idiopathic Hypoparathyroidism

Purpose: To report a case of profoundly characteristic cataract associated with idiopathic hypoparathyroidism. Methods: We described a 37-year-old male presented to our hospital with bilateral vision loss for 3 years. Past medical history included recurring tetany and convulsion, regarded as grand mal epilepsy about 9 years prior to diagnosis of hypoparathyroidism and corresponding administration. Ophthalmic signs of typically lenticular changes in both eyes, combined with laboratory evidence of hypocalcemia and significantly decreased parathyroid hormone (PTH) level, led to a diagnosis of hypoparathyroid cataract. The patient subsequently underwent unilateral phacoemulsification and multifocal intraocular lens implantation surgery. Results: At the first postoperative day, the best-corrected distance visual acuity (BCDVA) improved from 0.5 logMAR preoperatively to 0.0 logMAR; the uncorrected distance visual acuity (UCDVA) was 0.1 logMAR and the uncorrected near visual acuity (UCNVA) at 40 cm was 0.1 logMAR. The visual acuity remained stable during 1 year of follow-up. Conclusions: These observations suggest that cataracts associated with idiopathic hypoparathyroidism possess characteristic manifestations, and long standing severe hypoparathyroidism and hypocalcemia increase the risk of cataract. In addition, the relevant medical history and laboratory examinations are important for the diagnosis of such cases. Surgically removed the cataract with serious visual impairment is advised.