8/3/2019 Bilateral Spontaneous Anterior Dislocation of
Crystalline Lens
1/1
www.thelancet.com Vol 378 October 22, 2011 1501
Clinical Picture
Lancet 2011; 378: 1501
Published Online
August 26, 2011
DOI:10.1016/S0140-
6736(11)60313-9
Department of
Ophthalmology, Advanced Eye
Centre, Post Graduate Institute
of Medical Education and
Research, 160012 Chandigarh,
India (Prof J Ram MS,
N Gupta MS)
Correspondence to:
Prof Jagat Ram, Department of
Ophthalmology, Advanced Eye
Centre, Post Graduate Institute of
Medical Education and Research,
160012 Chandigarh, India
[email protected]
Bilateral spontaneous anterior dislocation of crystalline
lens
in an infantJagat Ram, Nishant Gupta
A 9-month-old boy presented with photophobia of2-week duration
in both eyes. There was no history oftrauma. Ocular examination
showed bilateral anteriordislocation of crystalline lenses into the
anteriorchamber. Examination under anaesthesia showed thedimensions
of the right cornea to be 135 mm(horizontal) 130 mm (vertical) and
the left cornea to be145 mm 140 mm. Intraocular pressure was 12 mm
Hgin each eye. Systemic examination did not show any
abnormalities. His family history was unremarkable.The fundus
was normal in both eyes. A diagnosis of
bilateral spherophakia and megalocornea with anteriordislocation
of crystalline lenses was made. The crystallinelenses were removed
through a limbal incision in theright eye and lensectomy with
anterior vitrectomy inthe left eye. Postoperatively, the child was
visuallyrehabilitated with aphakic glasses. Trans-scleral
fixationof intraocular lens will be done after stabilisation of
axialgrowth. Bilateral spontaneous anterior dislocation
ofcrystalline lens is a rare condition in spherophakia,
necessitating prompt diagnosis and management toavoid glaucoma
and corneal endothelial cell damage.
Figure:Anterior dislocation of crystalline lens
(A) Bilateral simultaneous anterior dislocation; (B) magnified
view of anteriorly dislocated crystalline lens with dilated
pupil.
A B
