Can You Have Crystals in Your Eyes?

Cystinosis is a rare, inherited disorder that affects the body's ability to process an amino acid called cystine. Cystine is a protein-building block found in all cells of the body. Cystine crystals can accumulate in cells throughout your body, including your eyes. The accumulation of cystine can cause various serious health problems. Cysteine crystals in the cornea are typically needle-shaped, resembling shards of glass. 

There are several types of cystinosis, including:

• Infantile nephropathic cystinosis: The most severe form of cystinosis, which is characterized by the accumulation of cystine in the kidneys and other organs.
• Intermediate cystinosis: A milder form of the disease that may not cause serious kidney damage.
• Adult cystinosis: The mildest form of the disease and often causes few symptoms. Only the eyes are affected and crystals are seen in the cornea.

Cystinosis is treated with medications that help remove excess cystine from the body and prevent kidney damage. People with the disease may also need medications to manage other symptoms and complications.

Crystal deposits are usually seen in the cornea, lens, and vitreous of the eye.

• Cornea
  • One common condition that can cause crystals to form in the eyes is called crystalline keratopathy.
  • This occurs when small, crystal-like particles build up on the cornea and can cause vision problems, such as eye irritation and discomfort.
  • Crystalline keratopathy can be caused by various factors, including dry eye syndrome and certain medications/medical conditions, such as diabetes or Sjögren's syndrome.
• Lens
  • Crystalline deposits can also form in the lens of the eye, a condition called cataracts.
  • Cataracts are cloudy areas that form in the lens and can cause vision problems, such as difficulty seeing at night or in low light, glare, or halos around lights, and double vision.
  • Cataracts are typically treated with surgery to remove the cloudy lens and replace it with a clear artificial lens.
• Vitreous
  • Crystalline deposits can form in the vitreous, a condition called vitreous opacities or vitreous floaters.
  • These deposits can appear as small dots, strands, or cobwebs in the field of vision and can be annoying, but they usually do not cause serious vision problems.

Crystals that form in the eyes can be made of various substances, depending on the underlying cause of their formation.

Some common substances that can form crystals in the eyes include:

• Cystine
  • Cystine crystals can form in people with a rare inherited disorder called cystinosis.
  • Cysteine is a nonessential amino acid (protein building block), which can be synthesized in the human body.
  • In people with cystinosis, an excess of cystine accumulates in cells, particularly in the kidneys, eyes, muscles, and brain.
• Calcium
  • Calcium crystals can form in the cornea (the clear, front part of the eye) because of certain medical conditions or medications.
  • Additionally, calcium crystals can form in the vitreous (the gel-like substance that fills the middle of the eye) and can be seen as small dots or strands in the field of vision.
• Protein
  • Crystals can form in the lens of the eye, a condition called cataracts.
• Other substances/conditions
  • Substances such as certain medications or some conditions such as infections or inflammation can also cause crystals to form in the eyes.

The symptoms of crystals in the eyes can vary depending on the underlying cause of the crystal formation and the location of the crystals.

Some common symptoms associated with crystals in the eyes include:

• Vision problems
  • Crystals in the cornea or lens can cause vision problems, such as blurriness, difficulty seeing at night or in low light, and glare or halos around lights.
  • Crystals in the vitreous can appear as small dots or strands in the field of vision and can be annoying, but they usually do not cause any serious vision problems.
• Eye irritation and discomfort
  • Crystals in the cornea can cause eye irritation and discomfort, such as dryness, redness, and sensitivity to light.
• Excessive thirst and frequent urination
  • Crystals in the kidneys can cause kidney problems, leading to excessive thirst and frequent urination.
• Failure to grow and gain weight at a normal rate
  • Crystals in the kidneys can cause kidney problems, leading to poor growth and weight gain in children.
• Muscle weakness
  • Crystals in the muscles can cause muscle weakness.

Crystals in the eyes can cause a variety of problems and impact eye health. The severity depends on the underlying cause of crystal formation and the location of the crystals in the eye.

Some common effects of crystals on eye health include:

• Vision problems
  • Crystals in the cornea or lens can cause vision problems, such as blurriness, difficulty seeing at night or in low light, and glare or halos around lights. 
  • Crystalline keratopathy can cause vision problems and eye irritation. 
  • Cataracts, caused by crystals can cause vision problems such as difficulty seeing at night or in low light, glare, or halos around lights and double vision. 
  • Crystals in the vitreous, can appear as small dots or strands in the field of vision and can be annoying, but they usually do not cause any serious vision problems.
• Eye irritation and discomfort
  • Crystals in the cornea can cause eye irritation and discomfort, such as dryness, redness, and sensitivity to light.
• Damage to the cornea
  • Crystalline keratopathy can cause scarring and damage to the cornea, which can cause vision problems and increase the risk of infection.
• Increased risk of infection
  • Damage to the cornea caused by crystals can increase the risk of infection as the cornea protects the eye from various irritants and infection-causing organisms.

Crystals in the eyes can be diagnosed by an eye doctor (ophthalmologist) through a thorough examination of your eye. During the exam, the eye doctor will examine the front and back of your eyes, including the cornea, lens, and vitreous, to look for any signs of crystals.

The eye doctor may also perform other tests to help diagnose crystals in the eyes, such as:

• Slit lamp examination: During this test, the eye doctor uses a special instrument called a slit lamp to examine the front of your eye, including the cornea and lens, in detail. The slit lamp has a magnifying lens along with a bright light source that allows the eye doctor to see the inside of the eye clearly.
• Refraction test: Measures how light is refracted (bent) as it passes through the eye and helps determine the correct eyeglass or contact lens prescription.
• Visual acuity test: Measures how your eyes see at different distances.
• Tonometry: Is used to measure the pressure inside the eye.
• Fundus examination: During this test, the eye doctor uses a special instrument called an ophthalmoscope to examine the back of the eye, including the retina, optic nerve, and blood vessels.

Additional tests such as imaging tests can confirm the diagnosis and determine the underlying cause of the crystal formation.

The treatment options for crystals in the eyes depend on the underlying cause of the crystal formation and the location of the crystals in the eye.

Some common treatment options for crystals in the eyes include:

• Medications
  • Certain medications, such as artificial tears, can be used to manage dry eye syndrome and prevent infection in people with crystalline keratopathy (crystals on the cornea).
  • Topical cysteamine drops are used to reduce the accumulation of corneal deposits.
• Surgery
  • In some cases, surgery may be necessary to remove crystals from the eye.
  • For example, cataract surgery can be used to remove protein crystals from the lens of the eye.
  • Corneal surgery may be necessary to remove crystals from the cornea and repair any damage caused by the crystals.
  • A retinal transplant is an option for severe cystinosis.
• Regular eye examinations
  • Are important for monitoring the progression of crystal formation and any vision changes.