A 56-year-old man comes to the physician because of progressive worsening of vision in both eyes over the past 6 months. The patient reports that during this period he has had blurry vision and a glare in the evenings. The patient has systemic lupus erythematosus, which is treated with hydroxychloroquine and prednisone. She avoids sun exposure due to photosensitivity and has vitamin D deficiency for which she takes a vitamin D supplement. Ophthalmologic examination shows visual acuity of 20/100 in both eyes. Ocular movements are full. The remainder of the examination shows no abnormalities. Which of the following is the most significant contributing factor for the eye findings in this patient?

Question

A 56-year-old man comes to the physician because of progressive worsening of vision in both eyes over the past 6 months. The patient reports that during this period he has had blurry vision and a glare in the evenings. The patient has systemic lupus erythematosus, which is treated with hydroxychloroquine and prednisone.  She avoids sun exposure due to photosensitivity and has vitamin D deficiency for which she takes a vitamin D supplement. Ophthalmologic examination shows visual acuity of 20/100 in both eyes. Ocular movements are full.  The remainder of the examination shows no abnormalities.  Which of the following is the most significant contributing factor for the eye findings in this patient?

Quizplus · Accepted Answer

Eductional Objective: Cataracts are related primarily to chronic photooxidative injury. Most patients with cataracts first develop symptoms at age >60 but exposure to systemic or ophthalmic glucocorticoids can cause cataracts at an early age. Other causes of premature cataract formation include diabetes mellitus, ocular trauma, and external radiation exposure.

A 56-Year-Old Man Comes to the Physician Because of Progressive