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Quick Hit: Traumatic Lens Dislocation

Although lens dislocation occurs infrequently after blunt eye trauma, trauma is the most common cause of lens dislocation... Traumatic lens dislocation (TLD) often occurs after a direct blow to the eye, as with a baseball or golf ball, or after blunt trauma to the head. It has also been associated with airbag injuries.

Patients with prior ophthalmologic surgery or connective tissue disorders often have weakness of the zonule fibers and are at increased risk for lens dislocation even after minor trauma. Certain conditions such as retinitis pigmentosa, homocystinuria, Marfan syndrome, Ehlers-Danlos, and tertiary syphilis are also associated with lens dislocation.

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 Banging Bungies: Viewing Traumatic Eye Injuries Through a New Lens

Eye trauma is reportedly present in 1.5% of emergency department visits, but lens dislocation, or ectopia lentis, makes up a low proportion of those visits overall. Although connective tissue disorders such as Marfans syndrome can lead to spontaneous dislocation, far more commonly this injury follows trauma.

Articles of Interest

Bedside Ocular Ultrasound Diagnosis of a Traumatic Lens Dislocation

Lens dislocations are a relatively uncommon etiology of acute traumatic vision changes predominantly caused by blunt eye trauma, which may develop significant complications such as worsening vision loss, cataract formation, retinal detachment, or glaucoma.

Bump and blur

There are two types of traumatic lens displacement (aka ectopia lentis): Dislocation — anterior or posterior displacement of the lens resulting from complete disruption of the lens zonule fibers. Subluxation — results from incomplete disruption of the lens zonule fibers

Diagnose on Sight: Traumatic Vision Loss

Crystalline lens dislocation, also referred to as ectopia lentis, most commonly occurs secondary to ocular trauma. Disruption of the zonular fibers which hold the lens in place allow the migration of the lens. If the lens completely dislocates it can be found in the anterior chamber, free-floating in the vitreous, or over the retina.

How to Manage Dislocated IOLs

Most cataract procedures are performed with no complications. The IOL is placed securely in the capsular bag, and it stays there for the duration of the patient’s life. However, in some cases, the IOL can become dislocated to the point where a secondary intervention is required.

Lens on the Loose!

While not a common occurrence, patients sometimes present with a “lens on the loose.” In such situations, don’t panic! Assess the severity of the condition, manage the optical complications, and obtain a surgical consultation if indicated. Modern technology permits these patients to enjoy restored ocular health and vision.

Spontaneous lens dislocation: why it occurs, when, management, and other insights

Lens dislocation is a spectrum. It can be anywhere from a small amount of decentration to a complete dislocation with the IOL-capsular bag complex sinking into the posterior chamber or falling into the vitreous.

Traumatic lens dislocation

Point-of-care ultrasound can be a useful tool to make a rapid diagnosis of ocular emergency including lens abnormality.

WikiDoc

Ectopia lentis is a displacement or malposition of the eye's crystalline lens from its normal location. A partial dislocation of a lens is termed lens subluxation or subluxated lens; a complete dislocation of a lens is termed lens luxation or luxated lens.