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

2. 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

3. 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

4. Subluxation of lens Inherited Causes Marfan’s syndrome
Weil Marchesani syndrome
Homocystinuria
Aniridia
Hyperlysinemia
Familial ectopia lentis

5. Subluxation of lens Acquired Causes Trauma
Large eye [myopia,buphthalmos]
Hypermature cataract

6. 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

7. 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

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

9. 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 ]

10. Removal of the lens with a cryoprobe

11. 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

12. Complicated cataract
Secondary to primary ocular disease
Secondary to inflammatory or degenerative diseases
Anterior or posterior uveitis : A + PSC
Acute congestive glaucoma : Glaucomflecken

13. 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

14. 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

15. 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 ]

16. Do you have any questions ?