代謝相關白內障

代謝相關之Cataract（遺傳型多為AR）

* diabetic cataract
=> 有acute myopic shift或年輕人很早就有accommodation↓
=> 屬於snowflake cataract
=> myltiple gray-white subcapsular opacity

* Glalactosemia
=> 缺 GPUT ( galactose-1-1phosphate uridyl transferase )
=> 無法將galactose轉成glucose
=> AR inheritance
=> 有三個可能的enzyme defect，其中以transferase最常見
=> 若未即時診斷，甚至可能致死
=> 75%有cataract
=> Central oil droplet cataract （opacity在nucleus及deep cortex）
=> Multicolor, fleck cataract, 跟myotonic dystrophy一樣的外狀
=> Treatment: 限制milk intake
=> 思考： 因為是可治療且若未治療可致死的小兒疾病，故若發現小朋友有雙眼白內障，最重要的檢查就是check RBC galactokinase level

* hypocalcemia （tetanic cataract）
=> 可由傷到parathyroid gland引起

* Wilson diseas (Hepatolenticular degeneration)
=> AR inherited
=> sunflower cataract (subcapsular cortex opacity)
=> ant. capsule也會有紅棕色的Cuprous oxide沈積
=> 角膜病變： Kayer-Flescher ring - Golden-brown discoloration of peripheral Decement's membrane (不要和keratoconus的Flescher ring搞混。真的記不起來的話，只好用粗鄙的口訣了： KF+Cu = FUCK！)