Sunflower cataract: A rare diagnostic marker in Wilson disease

Abstract

The occurrence of sunflower cataracts (SCs) is rarely reported in Wilson's disease (WD). We present a case of a 13-year-old female patient who was transferred from a general medical OPD to an Ophthalmology OPD with a preliminary diagnosis of Wilson's disease. The patient was asymptomatic. The patient was complaining about hemiparesis on the right side,slurring of speech, tingling and numbness on the right side of the arm/face 4 months ago and was progressive in nature. During the examination, unaided vision was 6/6 in both eyes, and pupils were central, cyclical and reactive to light. During the slit lamp examination, the conjunctiva and pupils were normal in both eyes. Sunflower cataract and a 3 mm Kayser Fleischer (KF) ring around the limbus were found in both eyes. On dilated fundus examination, both eyes were 0.4 CDR, circular, hyperemic disc, FR present. Laboratory tests included SGPT 36U/L, SGOT 199U/L, S. Ceruloplasmin <3 mg/dL, 24 hours urinary copper 470.28 micrograms, rest normal and negative. MRI brain shows giant panda face signs (bilateral thalamic hyperintensity). Based on clinical investigation and examination, we provided a diagnosis of sunflower cataracts in Wilson's disease.

Keywords: KF Ring, Sunflower cataract, Wilson’s disease