SELAMAT DATANGSELAMAT DATANG Dr. SANTHOSH

ASSISTANT PROFESSORDEPARTMENT OF OPHTHALMOLOGY K.M.C. MANIPAL

Ectopia lentisEctopia lentis

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 lensSubluxation of lens

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 lensSubluxation of lens

Inherited

Causes Marfan’s syndrome Weil Marchesani syndrome Homocystinuria Aniridia Hyperlysinemia Familial ectopia lentis

Subluxation of lensSubluxation of lens

Acquired

Causes Trauma

Large eye [myopia,buphthalmos]

Hypermature cataract

Subluxation of lensSubluxation 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

Dislocation of lensDislocation of lens

Definition : complete displacement of the lens from the pupillary area.

Types : anterior or posterior

Symptoms: pain, redness, blurring of vision

Signs: Depends on the type of dislocation

Dislocation of lensDislocation of lens

Complications :

Corneal endothelium touch Secondary glaucoma

Vitreous haemorrhage Retinal tear Retinal detachment Chronic uveitis .

Dislocation of lensDislocation of lens

Management In anterior dislocation – remove with a vectis using

viscoelastics

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 Removal of the lens with a cryoprobecryoprobe

Complicated cataract

Secondary to primary ocular disease

[Secondary to inflammatory or degenerative diseases]

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

Anterior or posterior uveitis : A + PSC Acute congestive glaucoma : Glaucomflecken

QuestionsQuestions

Defination of subluxation and dislocationCauses for subluxation and dislocationSigns/symptoms of subluxation and

dislocationManagement of subluxation and dislocationSigns and management of complicated

cataract

RuebellaRuebella CataractCataract

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

Microphthalmos Retinopathy [ salt and

pepper appearance]

Glaucoma

Abnormalities of lens shapeAbnormalities of lens shape

Coloboma [ involves the iris and choroid] Anterior lenticonus Posterior lenticonus Lentiglobus

Microphakia [ Diameter is smaller than normal eg. in Lowe’s syndrome ]

Microspherophakia [ + disc like in eg. Marfans syndrome ]

Do you have any questions ?Do you have any questions ?