Rapid formation of cataract after starting ziprasidone with spontaneous regression after therapy was discontinued

A 48-year-old diabetic woman with bipolar disorder presented with rapid onset of blurred vision after starting the antipsychotic drug ziprasidone. On examination, she was found to have advanced cataracts with a prominent posterior subcapsular component. Because her preoperative blood sugar levels had become elevated while on ziprasidone, the patient discontinued the medication before uneventful cataract surgery in the right eye. Postoperatively, the blood sugar level was improved; simultaneously, she noticed an improvement in vision in not only her operated eye but also her unoperated left eye. Examination showed near-complete resolution of the cataract in the left eye. We propose that initiation of therapy with ziprasidone in this patient promoted formation of bilateral cataracts, possibly through its hyperglycemic effect, while its cessation led to cataract regression in the unoperated eye.