Published online Sep 16, 2022. doi: 10.12998/wjcc.v10.i26.9378
Peer-review started: April 6, 2022
First decision: June 16, 2022
Revised: July 2, 2022
Accepted: August 5, 2022
Article in press: August 5, 2022
Published online: September 16, 2022
Hypoparathyroidism is uncommon, and cataracts secondary to hypoparathyroidism are even rarer. Herein, we report a case of bilateral cataracts following hypoparathyroidism.
A 27-year-old man presented to our hospital because of painless and progressive visual impairment of both eyes over two years. He was previously diagnosed with hypocalcemia but did not take calcium supplements regularly. He had no history of anterior neck thyroid surgery. After admission, the biochemical analysis indicated a serum calcium level of 1.21 mmol/L and an intact parathyroid hormone level of 0 pg/mL. Ocular examination revealed bilateral symmetrical opacity of the lens presenting as punctate opacity in the posterior subcapsular cortex together with radial opacity in the peripheral cortex (N1C2P3). Phacoemulsification with an intraocular lens was performed in both eyes sequentially. Postoperatively, the patient had a satisfactory recovery and greatly improved visual acuity.
This patient had hypocalcemia owing to idiopathic parathyroid insufficiency. Hypoparathyroidism may go unnoticed for years but with some latent clinical manifestations, such as bilateral symmetrical posterior subcapsular cataracts. This case report highlights that the cause of hypocalcemia in particularly young patients should be further investigated. Clinicians should be aware of hypoparathyroidism as a cause of bilateral cataracts. Early identification of hypoparathyroidism can save patients from further complications.
Core Tip: Bilateral hypocalcemic cataracts secondary to hypoparathyroidism are rarely observed in ophthalmology. The main clinical manifestation is convulsions caused by hypocalcemia in the early stage. Here, we report a case of bilateral cataract with previously diagnosed hypocalcemia but for the first time to find the cause of idiopathic parathyroid insufficiency. Hypoparathyroidism may go unnoticed for years but with some latent clinical manifestations, such as bilateral symmetrical posterior subcapsular cataracts. The cause of hypocalcemia in particularly young patients should be investigated.