Transcript Lens 2 - Tripod.com

SELAMAT DATANG
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Dr. SANTHOSH
ASSISTANT PROFESSOR
 DEPARTMENT OF OPHTHALMOLOGY
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K.M.C. MANIPAL
Ectopia lentis
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Displacement of the lens
from its normal position
It is either completely displaced [dislocated ] or
partially displaced [ subluxated]
 May be inherited or acquired
Subluxation of lens
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Definition : Partial displacement of the lens
: Occurs when the zonules are torn in
one segment
: It still remains in the pupillary area
: Displaced opposite.
Causes
Inherited
Acquired
Subluxation of lens
Inherited
Causes
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Marfan’s syndrome
Weil Marchesani syndrome
Homocystinuria
Aniridia
Hyperlysinemia
Familial ectopia lentis
Subluxation of lens
Acquired
Causes
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Trauma
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Large eye [myopia,buphthalmos]
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Hypermature cataract
Subluxation of lens
Symptoms : depends whether it’s anterior or posterior
diplopia
pain
redness
blurring of vision
 Indications for surgery : Diplopia
: Lens induced uveitis
: Secondary glaucoma
 Management : Leave alone if the patient is asymtomatic.
: Removal of the lens with a vectis or ICCE
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Dislocation of lens
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Definition : complete displacement of the lens from
the pupillary area.
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Types : anterior or posterior
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Symptoms: pain, redness,
blurring of vision
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Signs: Depends on the type of dislocation
Dislocation of lens
Complications :
Corneal endothelium touch
Secondary glaucoma
Vitreous haemorrhage
Retinal tear
Retinal detachment
Chronic uveitis .
Dislocation of lens
Management
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In anterior dislocation – remove with a vectis
using viscoelastics
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In posterior disclocation- Total vitrectomy and
floating the lens using heavy liquids or using a
fragmentome to break the nucleus and removing the
pieces.
Or leave alone if there are no complications.
Spectacle correction [aphakic ]
Removal of the lens with a
cryoprobe
Complicated cataract
Secondary to primary ocular disease
[Secondary to inflammatory or degenerative diseases]
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Anterior or posterior uveitis : A + PSC
Acute congestive glaucoma : Glaucomflecken
High myopia : Post lens opacities and PSC
 Hereditary retinal + vitreoretinal disorders: PSC
Complicated cataract
Secondary to primary ocular disease
Secondary to inflammatory or degenerative diseases
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Anterior or posterior uveitis : A + PSC
 Acute congestive glaucoma : Glaucomflecken
Questions
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Defination of subluxation and dislocation
 Causes for subluxation and dislocation
 Signs/symptoms of subluxation and
dislocation
 Management of subluxation and dislocation
 Signs and management of complicated
cataract
Ruebella
Cataract
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Foetal infection from
maternal viremia
 Within 6/52 the virus
can penetrate the lens
capsule
 Nuclear cataract
 Virus can persist in the
lens for 3 years
postnatally
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Microphthalmos
 Retinopathy [ salt and
pepper appearance]
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Glaucoma
Abnormalities of lens shape
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Coloboma [ involves the iris and choroid]
 Anterior lenticonus
 Posterior lenticonus
 Lentiglobus
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Microphakia
[ Diameter is smaller than normal eg. in Lowe’s syndrome ]
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Microspherophakia [ + disc like in eg. Marfans syndrome ]
Do you have any questions ?