SELAMAT DATANG

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SELAMAT DATANG

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

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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

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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

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Subluxation of lens

• Inherited
• Causes
• Marfans syndrome
• Weil Marchesani syndrome
• Homocystinuria
• Aniridia
• Hyperlysinemia
• Familial ectopia lentis

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Subluxation of lens

• Acquired
• Causes
• Trauma
• Large eye myopia,buphthalmos
• Hypermature cataract

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Subluxation of lens

• Symptoms depends whether its 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

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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

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Dislocation of lens

• Complications
• Corneal endothelium touch
• Secondary glaucoma
• Vitreous haemorrhage
• Retinal tear
• Retinal detachment
• Chronic uveitis .

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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

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Removal of the lens with a cryoprobe
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• 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

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

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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

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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

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Abnormalities of lens shape

• Coloboma involves the iris and choroid
• Anterior lenticonus
• Posterior lenticonus
• Lentiglobus
• Microphakia
• Diameter is smaller than normal eg. in
  Lowes syndrome
• Microspherophakia disc like in eg. Marfans
  syndrome

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Do you have any questions ?