Mrs. Kamala, a 70-year-old retired tailor, presents with a two-year history of gradual, painless, and progressive blurring of vision in both eyes, which she describes as an increasing “mistiness.” This impairment has significantly impacted her quality of life ,forcing her to quit sewing as she can no longer thread a needle. She reports marked “glare” when outdoors in bright sunlight and observes “halos” around streetlights at night.
She is not a known diabetic, denies symptoms of polyuria or polydipsia, and has no history of chronic steroid use, headaches, or “tunnel vision” and states her night vision was perfectly fine until the general blurring started. No family history of early-onset blindness.

On examination,

Her visual acuity is 6/24 in the right eye (RE) and 6/60 in the left eye (LE), with the latter showing no improvement with a pinhole.
Anterior segment slit-lamp examination reveals a clear cornea and a quiet anterior
chamber of normal depth. The pupils are briskly reactive with no Relative Afferent
Pupillary Defect (RAPD). However, the RE lens shows peripheral wedge-shaped
opacities while the LE lens exhibits a dense, pearly-white opacification with an absent iris shadow.