High Lenticular Myopic and Astigmatic Shift in Grade 3 Nuclear Sclerosis Cataract: A Case Report

Abstract

Background: Nuclear sclerosis cataract is a well-known cause of lenticular (index) myopia; however, the degree of refractive change is usually mild to moderate. Extreme myopic shift accompanied by significant astigmatism is uncommon and may lead to diagnostic confusion.

Case Presentation: We report a case of a 61-year-old patient presenting with marked myopic and astigmatic shift (−7.00 D sphere with −3.00 D cylinder at 80°) associated with grade 3 nuclear sclerosis cataract. Ocular biometry demonstrated normal axial length and corneal curvature, excluding axial or corneal causes of myopia. The refractive changes were attributed to lenticular alterations induced by nuclear sclerosis.

Conclusion: This case highlights an unusual magnitude of lenticular myopic and astigmatic shift caused by nuclear sclerosis cataract. Awareness of this phenomenon is essential to avoid misdiagnosis and refractive surprise, and to emphasize the importance of comprehensive biometry in patients with unexpected refractive changes. 

Keywords: Nuclear sclerosis, lenticular myopia, myopic shift, astigmatism, cataract.