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   Table of Contents      
CASE REPORT
Year : 2018  |  Volume : 5  |  Issue : 1  |  Page : 32-33

Traumatic dislocation of lens


Department of Ophthalmology, DDU Zonal Hospital, Himachal Pradesh University, Shimla, Himachal Pradesh, India

Date of Submission25-Jul-2018
Date of Acceptance09-Apr-2020
Date of Web Publication11-Jul-2020

Correspondence Address:
Dr. Arti Sareen
Department of Ophthalmology, DDU Zonal Hospital, Himachal Pradesh University, Shimla, Himachal Pradesh
India
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DOI: 10.4103/bijo.bijo_5_18

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  Abstract 


Facial and ocular traumas are the most common cause of an accidental posterior Dislocation of the crystalline lens; regardless of its severity. Syndromic ectopia lentis, like in Marfan , Homocystinuria and Ehlers-Danlos syndromes can be presented in early childhood. To report a case of left long standing posterior dropped crystalline lens in a quite eye by minor wooden stick blunt trauma. A 55-years adult gentleman who is free from any congenital disorder; was presented with 6-months history of bilateral visual defects, where more in the left eye (OS) could be attributed to mild wooden stick blunt trauma. On examination; right eye (OS) bet corrected visional acuity (BCVA) was 6/12 OD and 3/60 OS. The OS was found to be aphakic due to quite posteriorly dropped crystalline lens.

Keywords: Dislocation, ectopia lentis, ehlers-danlos syndrome, homocystinuria, trauma, marfan


How to cite this article:
Sharma M, Sareen A, Negi SS. Traumatic dislocation of lens. Albasar Int J Ophthalmol 2018;5:32-3

How to cite this URL:
Sharma M, Sareen A, Negi SS. Traumatic dislocation of lens. Albasar Int J Ophthalmol [serial online] 2018 [cited 2021 Sep 16];5:32-3. Available from: https://www.bijojournal.org/text.asp?2018/5/1/32/289596




  Introduction Top


Ectopia lentis is defined as the displacement or malposition of the crystalline lens of the eye. The lens is considered dislocated when it lies completely outside the patellar fossa, in the anterior chamber, free-floating in the vitreous, or directly on the retina. Trauma is the most common cause of dislocation of the lens. Partial or complete disruption of the zonular fibers leads to subluxation or dislocation of the lens into the posterior chamber.[1]


  Case Report Top


A 55-year-old man presented with the chief complaint of diminution of vision in his left eye for the last 6 months. On further questioning, he complained of minor blunt trauma to his left eye with a wooden stick. On examination, his visual acuity was 6/24 in the right eye and 3/60 in the left eye with no improvement with pinhole. His vision improved to 6/12 with + 10 D. Slit lamp examination showed cataractous changes in his right eye and aphakia in his left eye. On further examination, lens was seen floating in the vitreous [Figure 1]. Fundus photograph was also taken and the lens could be seen, as shown below [Figure 2].
Figure 1: Anterior segment photograph showing lens in the vitreous

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Figure 2: Fundus photograph of the patient with dislocated lens

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  Discussion Top


Ectopia lentis is defined as the displacement or malposition of the crystalline lens of the eye. The lens is considered dislocated when it lies completely outside the patellar fossa, in the anterior chamber, free-floating in the vitreous, or directly on the retina. Trauma is the most common cause of dislocation of the lens. Partial or complete disruption of the zonular fibers leads to subluxation or dislocation of the lens into the posterior chamber.[1]

In the absence of trauma, ectopia lentis should evoke suspicion for concomitant hereditary systemic disease or associated ocular disorders.[2] Simple ectopia lentis can occur as a congenital disorder or as a spontaneous disorder later in life. Mutations to ADAMTSL4 gene located on chromosome 1 and FBN1 gene located on chromosome 15 may be involved. These mutations result in irregularity and degeneration of the zonular fibers, leading to lens dislocation. Ectopia lentis is a common feature of genetic syndromes, such as Marfan syndrome and Weill-Marchesani syndrome.[3] Ectopia lentis et pupillae is a rare congenital disorder in which there is asymmetric eccentric pupils that are displaced in the opposite direction of the lens dislocation.

Although it was believed that it can be treated with aphakic glasses, now surgical treatment is recommended due to increased incidence of delayed complications. Dislocated lens may lead to allergic uveitis, retinal detachment, and phacolytic glaucoma.[4]

Ectopia lentis may cause marked visual disturbance, which varies with the degree of lens displacement and the underlying etiologic abnormality. The following pictures depict the lens dislocated into the vitreous.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Salehi-Had H, Turalba A. Management of traumatic crystalline lens subluxation and dislocation. Int Ophthalmol Clin 2010;50:167-79.  Back to cited text no. 1
    
2.
Clark CC. Ectopia lentis: A pathologic and clinical study. Arch Ophthalmol 1939;21:124-53.  Back to cited text no. 2
    
3.
Duane T. Cataracts and systemic disease. Duane's Clin Ophthalmol 1999;5:13-4.  Back to cited text no. 3
    
4.
Jurman M, Jones WL, Harris SL. Traumatic dislocation of the crystalline lens with delayed total retinal detachment. J Am Optom Assoc 1990;61:285-90.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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