Oil Droplet

• Commonly seen in patients with galactosemia (a recessively inherited inborn error of carbohydrate metabolism).
• Accumulation of dulcitol (galactose reduction product) within the lens cells leads to increased intracellular osmotic pressure and fluid influx into the lens.

Clinical Features

• Symptoms: decreased vision depends on the severity of the cataract
• Signs:
  • Bilateral lens changes
  • Zonular or nuclear opacity with increased refractive power of the nuclear portion causes an "oil droplet" appearance on retroillumination
  • Lenticular myopia
  • May progress to total opacification of the lens if the systemic condition is left untreated

Management

• Remove galactose from the diet
• Avoid all milk products to prevent the progression of cataract and mental retardation.