Lens Dislocation or Subluxation
This condition results from the complete or partial rupture of the zonular fibers. Partial rupture causes the lens to shift in the direction opposite to the damaged zonule. Part of the lens equator may be visible in the pupillary area, often accompanied by iridodonesis, astigmatism, or monocular diplopia. Complete lens dislocation may result in several outcomes:
- Dislocation into the anterior chamber or impaction within the pupillary area can lead to acute secondary glaucoma and corneal endothelial damage.
- Dislocation into the vitreous humor results in deepening of the anterior chamber, iridodonesis, and high hyperopia.
In cases of corneoscleral rupture, the lens could dislocate into the subconjunctival space.
Figure 1 Traumatic lens dislocation
The lens is shown completely dislocated into the anterior chamber, resulting in corneal edema due to contact between the lens and corneal endothelium.
Treatment involves surgical removal in cases where the lens is impacted in the pupil or dislocated into the anterior chamber. For subluxated lenses, correction of astigmatism with glasses may be attempted, though the outcomes are often suboptimal. Dislocation into the vitreous humor may cause complications such as secondary glaucoma or retinal detachment, warranting removal via vitrectomy.
Traumatic Cataract
Blunt trauma-induced lens opacities can assume various forms and are often associated with lens dislocation or subluxation, as well as damage to the iris and anterior chamber angle. Surgical treatment is considered based on visual impairment and patient requirements.