1. Examination of the lens by direct ophthalmoscopy

2. Abnormal lens features by direct ophthalmoscopy

By Hakimah Khani Binti Suhaimi

1. Examination of the lens by direct ophthalmoscopy

Normal Red Reflex

2. Abnormal lens features by direct ophthalmoscopy

2. Abnormal lens features by direct ophthalmoscopy

1. General.* a) Loss of normal red reflex.* (Fig. 3.9-3.11) b) Dark spots in red reflex.*c) Abnormal color of red reflex.*d) Spontaneous dislocation of lens.*

2. Lens abnormalities found in important ocular diseases.** a) Cataract (clouding or opacification of lens).**b) Implanted artificial intraocular lens.**

International Council of Ophthalmology

1 a) Loss of normal red reflex

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

1 b) Dark spots in red reflex

• Seen in congenital cataract.

1 c) Abnormal color of red reflex

• Probably due to cataract in retinoblastoma.

1 d) Spontaneous dislocation of lens (Luxation lentis)

with visible zonula fiberswith visible equator of lens

• A crescent-shaped red reflex seen in Marfan’s syndrome.

Pediatric & Strabismus: Marfans, Syndrome Subluxed Lens

2. Abnormal lens features by direct ophthalmoscopy

1. General.* a) Loss of normal red reflex.* (Fig. 3.9-3.11) b) Dark spots in red reflex.*c) Abnormal color of red reflex.*d) Spontaneous dislocation of lens.*

2. Lens abnormalities found in important ocular diseases.** a) Cataract (clouding or opacification of lens).**b) Implanted artificial intraocular lens.**

International Council of Ophthalmology

2 a) Cataract

• The most common cause of reversible blindness.• The degree of visual disabilities depends on the size and location of the

opacity. Axial opacities involving the nuclear or central subscapular areas cause much more disabling visual loss than the peripheral opacities

• This is a patient’s left eye.• The pupil is dilated.• Two white dots can be seen

under the slit-lamp.

Cataract: Anterior Polar Cataract Cataract: Mature Cataract

• This is a patient’s left eye.• The pupil is dilated and

covered by white opacity.

• This is the left eye of a patient.• The pupil is dilated.• The abnormality that can be seen here is a central opacity surrounded by

peripheral opacities.

Fig 2 Red reflex showing a nuclear cataract The presence of opacities in the reflex

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

Yellow colaration +

central opacity

• The yellow coloration of the nuclear cataract causes the patient to have yellow vision.

Cataract: Vision Yellow

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

Bradford CA. Basic ophthalmology. 8th ed. San Francisco, CA: American Academy of Ophthalmology; 2004

Langs, A Short Textbook Atlas of Ophthalmology

2 b) Implanted artificial intraocular lens

Cataract: OL Posterior

Cataract: IOL in Place Drawing

Cataract: PC IOL

Thank You