A 56-Year-Old Man Is Evaluated for Progressive Visual Impairment

A 56-year-old man is evaluated for progressive visual impairment.  The patient works as part of the grounds crew at an airport, and says he has trouble identifying aircraft at a distance and with filling out paperwork at the end of his shift.  His medical history includes poorly controlled diabetes mellitus, hypertension, and gout.  A year ago, the patient underwent an uncomplicated repair of a right inguinal hernia.  Physical examination shows bilateral clouding of the lens.  The remainder of the examination is unremarkable.  Which of the following metabolic conversions is most likely contributing to this patient's current condition?

A) Galactitol to tagatose
B) Galactose to galactitol
C) Glucose to sorbitol
D) Glucose-6-phosphate to 6-phosphogluconolactone
E) Pyruvate to lactate

Correct Answer:

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