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Last Month’s Blink

“Evanescent Cataract,” or Gas-Induced Lenticular Opacification

Written by Priya Bajgai, MBBS, and Ramandeep Singh, MBBS. Photos by Dr. Bajgai. Both are at Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

A 45-year-old man presented with com­plaints of diminish­ing vision in his right eye for 1 week. Fundus examination revealed a total retinal de­tachment with hand motion vision in that eye. The left eye was normal. He under­went pars plana vitrectomy with scleral buckle and a gas tamponade with sulfur hexa­chloride. On the first day postoperatively, the pos­terior segment examination revealed an attached retina with a 90% gas-filled eye. In addition, we observed a new-onset posterior subcapsular cata­ract, which had a ferning pattern (Fig. 1).

On subsequent follow-up appointments over 7 days, we saw the gradual disappearance of the cataract (Fig. 2) without any intervention, which is why we call it “evanescent cataract.” The reason for the disappearance is unclear; we attribute it mainly to gas-induced oxidative stress—as the gas was absorbed the cataract vanished.

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