Intended for healthcare professionals


A sparkling cataract

BMJ 2019; 364 doi: (Published 10 January 2019) Cite this as: BMJ 2019;364:k5212
  1. Zhenzhen Liu, ophthalmologist,
  2. Lixia Luo, professor of ophthalmology
  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
  1. Correspondence to L Luo luolixia{at}

Ophthalmoscope and slit lamp examination of a 73 year old man with progressive vision loss in his left eye showed an age related cataract and “sparkling” crystals in the lens (fig 1)

Sparkling cataract opacities (also known as Christmas tree cataracts) have been described as “glittering,” “multicoloured,” and “of polychromic lustre.” Proposed causes include defective lens metabolism, cholesterol formation, cystine accumulations, and light diffraction from fused cell membranes.123456

Prognosis is the same as for other types of cataracts.7 However, a sparkling cataract may indicate the presence of associated metabolic conditions—for example, myotonic dystrophy, chronic liver disease, and renal dysfunction.689 This patient had a history of chronic hepatic cirrhosis caused by schistosomiasis and left renal atrophy.



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