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Hypoparathyroidism related cataract in a patient with Fahr’s syndrome: A case report
First Author: I. EL Belhadji MOROCCO
Co Author(s): B. Jatik A. Mchachi R. Rachid M. ElBelhadji
To describe a case of rapid-onset bilateral cataract in a young patient with Fahrﾒs syndrome secondary to hypoparathyroidism.
Fahr's disease (idiopathic basal ganglia calcification) is a rare disorder in which there are calcium deposits in the basal ganglia as a complication of hypoparathyroidism. The Fahr triad consists of symmetrical calcification of the basal ganglia, neuropsychiatric symptoms, and hypofunction of the parathyroid gland.
A 24-year-old woman was addressed to the ophthalmology clinic with a complaint of rapidly progressive bilateral blurry vision. She had a history of epilepsy, hypoparathyroidism and severe hypocalcemia (60 ng/l), and was recently diagnosed with Fahrﾒs disease. Upon examination, her best corrected visual acuity (BCVA) was counting fingers, the eyelids presented a generalized cutaneous desquamation. She suffered from dry eye with reduced break-up time test bilaterally and superficial punctate inferior keratitis in both eyes. She presented a bilateral dense posterior subcapsular cataract associated to a cortical type. Fundoscopy was unsuccessful due to the density of the cataract.
The patient was prescribed artificial tears and ointment, and an ocular ultrasonography was requested to study the posterior segment. The biology assessment showed a persistent severe hypocalcemia even with supplementary treatment, which required to delay cataract surgery until the full stabilization of the patientﾒs clinical and biology assessment.
This case is noteworthy because it illustrates a rare etiology of cataracts in young patients, but also because it presents a challenge for its management, given that such cases of metabolic cataracts are at high risk of post-operative complications.
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