Trauma and lensTrauma and lens

Effects of blunt traumaEffects of blunt trauma

Vossius ring: Vossius ring: - A ring of faint or stippled brown amorphous A ring of faint or stippled brown amorphous

granules of iris pigments on the anterior granules of iris pigments on the anterior capsule . capsule .

- It has a diameter same as of contracted pupil It has a diameter same as of contracted pupil (due to traumatic miosis that results as (due to traumatic miosis that results as immediate effect of trauma)immediate effect of trauma)

- Results due to the impression of the iris on the Results due to the impression of the iris on the lens, produced by the force of the blow driving lens, produced by the force of the blow driving the iris backwardsthe iris backwards

- Minute discrete subcapsular opacities may be Minute discrete subcapsular opacities may be seen after resorption of the pigmentseen after resorption of the pigment

Concussion cataractConcussion cataract- Mechanism: due to entrance of aqueous Mechanism: due to entrance of aqueous

into the lens resulting from damage to into the lens resulting from damage to capsule either due to loss of its capsule either due to loss of its semipermeability or due to actual tears in semipermeability or due to actual tears in the capsulethe capsule

May occur in various forms:May occur in various forms:Discrete opacities involving the area of capsular tear Discrete opacities involving the area of capsular tear Rosette cataract:Rosette cataract:

- Early rosette: Early rosette: Usually starts in posterior cortex, sometimes the anterior Usually starts in posterior cortex, sometimes the anterior

cortex or both.cortex or both. Accumulation of fluid marks out the architechtural Accumulation of fluid marks out the architechtural

arrangement of the lens so that the star shaped cortical arrangement of the lens so that the star shaped cortical sutures are delineated and feathery lines of opacities sutures are delineated and feathery lines of opacities outlining the lens fibres radiate from themoutlining the lens fibres radiate from them

Rosette cataract may occasionally disappear, may Rosette cataract may occasionally disappear, may remain stationary or may progress to total opacification remain stationary or may progress to total opacification of the lensof the lens

- Late rosette:Late rosette:

Develops 2-3 yrs following the concussionDevelops 2-3 yrs following the concussion

Smaller and more compact than the early Smaller and more compact than the early rosette with shorter sutural extensionsrosette with shorter sutural extensions

Total cataractTotal cataract

Treatment Treatment

Delayed for a few months till the final Delayed for a few months till the final outcome is visible and inflammation outcome is visible and inflammation completely subsides, following which the completely subsides, following which the treatment is similar to any other unilateral treatment is similar to any other unilateral cataractcataract

Immediate treatment may be indicated if Immediate treatment may be indicated if lens becomes intumescent and secondary lens becomes intumescent and secondary glaucoma resultsglaucoma results

Other effects of blunt traumaOther effects of blunt trauma

Traumatic absorption of lens: may occur in Traumatic absorption of lens: may occur in childrenchildren

Subluxation/Dislocation of lensSubluxation/Dislocation of lens

Effects of penetrating traumaEffects of penetrating trauma

Rupture of the anterior capsule-> Rupture of the anterior capsule-> traumatic cataracttraumatic cataract

Vitreous in ACVitreous in AC

Effects of trauma on other structures of the Effects of trauma on other structures of the eyeeye