Bilateral hypocalcemic cataract after total thyroidectomy in an Ethiopian young woman: Case report

Introduction: Hypocalcemia is a derangement in serum calcium level due to a vast spectrum of disorders, but the most common cause is surgery, usually thyroid gland surgery. Symptoms of Hypocalcemia can be due to increased neuromuscular excitation resulting in tetany, paresthesia or seizure. It can also be because of deposition of calcium in soft tissues producing reduced vision /cataract or calcification of basal ganglia. Cataract is the most common ocular symptom of hypocalcemia. Case report: A twenty six years old Ethiopian female patient presented with painless reduction of vision of both eyes 5 years after she was diagnosed to have hypocalcemia with very low serum calcium level (3mg/dl) due to damage to the parathyroid gland during total thyroidectomy for toxic goiter and has been on supplemental calcium gluconate twice daily. She had typical bilateral symmetrical posterior sub capsular cataract with punctate iridescent opacities in the anterior and posterior cortex of the lens. Systemic examination revealed horizontal surgical scar on the anterior neck and Positive Chvostek sign. Conclusion:The work up of bilateral symmetrical cataract in young patients should include serum electrolyte levels, particularly calcium, in those who had history of thyroid surgery. Key words: Hypocalcemia, bilateral cataract, total thyroidectomy, hypoparathyroidism, tetany, serum calcium and Ethiopia.