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Shield-shaped cataract in severe atopic dermatitis

Published:March 18, 2021DOI:https://doi.org/10.1016/j.jcjo.2021.02.022
      A 32-year-old woman presented with a progressive decrease of vision in right eye and bilateral and severe skin eczema. The best-corrected visual acuity was 20/40 in the right eye and 20/20 in the left eye. The patient was previously diagnosed with atopic dermatitis. On slit-lamp examination, a shield-shaped anterior capsular cataract was observed, as well as an important anterior blepharitis. Although posterior subcapsular cataracts are more frequent in atopic dermatitis, shield-shaped cataracts are more specific to this disease. Topical and systemic steroids, mechanical effect owing to intense eye rubbing, intraocular inflammation, and decreased inducibility of superoxide dismutase have been proposed as possible explanations of this kind of cataract. However, the precise pathogenic mechanisms and risk factors for the development of atopic cataracts are still not clear.
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