Abstract
Background: Hyperbaric oxygen therapy (HBOT) is used to manage various medical conditions and has been associated with the gradual formation of cataracts after prolonged exposure. However, rapid-onset cataract development remains uncommon. This case describes an unusual presentation of rapid bilateral cataract development following HBOT, occurring over a much shorter timeframe than previously reported in literature.
Case presentation: A 56-year-old woman with hypertension, type 2 diabetes mellitus, and vascular disease experienced a rapid decline in vision following a 40-session, 2-month course of HBOT for a chronic venous leg ulcer. Before HBOT, best-corrected visual acuity had been documented as 20/20 in both eyes. After 2 months of treatment, ophthalmic examination demonstrated bilateral nuclear sclerotic cataracts with a best-corrected visual acuity of 20/40 in both eyes. There was no history of other known cataractogenic exposures. The patient underwent sequential, uncomplicated bilateral phacoemulsification with intraocular lens implantation to achieve mini monovision. Postoperatively, uncorrected visual acuity improved to 20/30 in the right eye and 20/20 in the left eye, with stable refractive outcomes at one month and well-centred lenses on examination.
Conclusions: The temporal association suggests that HBOT may be a potential contributor to accelerated cataractogenesis. Baseline and interval ophthalmic assessments should be considered for patients undergoing HBOT, particularly those with existing risk factors.
Keywords
Hyperbaric oxygen therapy (HBOT), Cataractogenesis, Nuclear sclerotic cataract, Rapid-onset cataract, Bilateral cataracts, Oxidative stress, Reactive oxygen species (ROS), Phacoemulsification, Case report