SELAMAT DATANG Dr. SANTHOSH ASSISTANT PROFESSOR DEPARTMENT OF OPHTHALMOLOGY K.M.C. MANIPAL

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

Subluxation of lens Acquired Causes Trauma Large eye [myopia,buphthalmos] 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

Dislocation 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 lens Complications : Corneal endothelium touch Secondary glaucoma Vitreous haemorrhage Retinal tear Retinal detachment Chronic uveitis .

Dislocation 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 cryoprobe

Secondary to primary ocular disease 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

Questions 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 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 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 ]

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