Presentation
We present 2 cases of intraocular lens (IOL) dislocation that appeared shortly after the patients exercised on a vibration platform. [ncbi.nlm.nih.gov]
Entire Body System
- Feeding Difficulties
The main clinical symptoms of these patients were: facial dysmorphic features, severe feeding difficulties, mental retardation, abnormal muscle tone, severe seizures and myoclonia. Four out of nine patients had dislocated eye lenses. [ncbi.nlm.nih.gov]
- Soft Tissue Swelling
He has no other evidence of trauma and the remainder of his examination is within normal limits. imaging CT scan of the head, face, and cervical spine demonstrate a left lens dislocation with pre-septal soft tissue swelling surrounding the left globe [tamingthesru.com]
Musculoskeletal
- Flexion Contracture
RESULTS: Pedigree analysis revealed a three generation family with eight of eleven individuals affected by early onset lens dislocation, high myopia, typical facies, frontal bossing, flexion contractures, proximal interphalangeal (PIP) joint thickening [ncbi.nlm.nih.gov]
- Thin Extremities
Case Report-II: The patient was a tall-statured 40-year old male with long, thin extremities. Arachnodactly, prognathis_raand a high arched palate were also present. [ijo.in]
Eyes
- Diplopia
Subluxation is one of the causes of monocular diplopia. If the luxation is complete the eye becomes markedly hyperopic and is unable to accommodate. [medical-dictionary.thefreedictionary.com]
Symptoms of these patients mainly included decrease in visual acuity (17 cases, 47.2%), blurred vision (16 cases, 44.4%), glare (1 case, 2.8%), diplopia (1 case, 2.8%), and halo (1 case, 2.8%). [ncbi.nlm.nih.gov]
Uniocular diplopia may result from partial aphakia. Anterior chamber becomes deep and irregular. Iridodonesis is usually present. [ikeyes.blogspot.com]
Patients may also complain of monocular diplopia and are at risk of developing amblyopia, glaucoma, and retinal detachment. Ectopia lentis can be inherited as an isolated condition, usually autosomal dominant (simple ectopia lentis). [visualdx.com]
While most clinicians immediately think of neurological problems when diplopia is mentioned, monocular diplopia is always attributed to some type of media issue, such as a cataract, corneal opacity or subluxated lens. [reviewofoptometry.com]
- Iridodonesis
These include: deep anterior chamber, aphakia in pupillary area, and iridodonesis. Ophthalmoscopic examination reveals lens in the vitreous cavity. [ikeyes.blogspot.com]
L21) See corectopia ; iridodonesis ; pupillary block. Fig. [medical-dictionary.thefreedictionary.com]
In the setting of lens dislocation, the patient may have trembling or shimmering of either the lens or iris, phakodenesis or iridodonesis, respectively. [tamingthesru.com]
Iridodonesis — trembling or shimmering of the iris after rapid eye movements in lens dislocation. Look for associated ocular and other injuries. Look for evidence of risk factors (e.g. [lifeinthefastlane.com]
Likewise, patients with subluxation may display iridodonesis, as well as focal deepening of the angle. [reviewofoptometry.com]
Psychiatrical
- Suggestibility
We report histologic findings from a retrospective case series from 1993 to 2010 and suggest a possible mechanism to explain this association. [ncbi.nlm.nih.gov]
Face, Head & Neck
- Frontal Bossing
RESULTS: Pedigree analysis revealed a three generation family with eight of eleven individuals affected by early onset lens dislocation, high myopia, typical facies, frontal bossing, flexion contractures, proximal interphalangeal (PIP) joint thickening [ncbi.nlm.nih.gov]
Workup
A workup was performed that included echocardiography, serologic testing for syphilis, and urine chromatography, all of which were unrevealing. [nejm.org]
Workup Cardiac evaluation for Marfan syndrome Serum and urine levels of homocysteine or methionine for homocystinuria Axial length measurement 32. [slideshare.net]
Treatment
Before surgery, 62 patients had either preexisting glaucoma (n = 39) or high IOP (≥22 mm Hg) with suspected glaucoma (n = 23), of whom several required preoperative IOP-lowering treatment. [ncbi.nlm.nih.gov]
TY - JOUR T1 - Medical treatment of crystalline lens dislocation into the anterior chamber in a patient with Marfan syndrome. [unboundmedicine.com]
Prognosis
The prognosis of the disease is poor; various attempts at treatment were not successful so far. Prenatal diagnosis by assay of sulfite oxidase in cultured amniotic fluid cells and by direct measurement of amniotic fluid S-sulfocysteine is possible. [ncbi.nlm.nih.gov]
The format includes the CPT codes for billing purposes, short description of the condition, etiology/incidence, course/prognosis, laboratory findings, differential diagnosis; prophylaxis, treatment (local and systemic, surgical or other), miscellaneous [books.google.de]
Treatment and prognosis Complications An anterior dislocation/subluxation carries greater complications than a posterior one. Such complications include: acute glaucoma corneal injury iridal injury Promoted articles (advertising) [radiopaedia.org]
If dislocation is partial and the lens is clear, visual prognosis is good. Traumatic lens dislocation can follow a blow to the eye. [tsbvi.edu]
Etiology
All charts were reviewed for etiology of dislocation, time elapsed from cataract surgery, best-corrected visual acuity (BCVA), slit-lamp examination, tonometry, and dilated fundus examination. [ncbi.nlm.nih.gov]
The format includes the CPT codes for billing purposes, short description of the condition, etiology/incidence, course/prognosis, laboratory findings, differential diagnosis; prophylaxis, treatment (local and systemic, surgical or other), miscellaneous [books.google.de]
etiology is capsular rupture during cataract surgery. [ophthalmologymanagement.com]
As ectopia lentis may be the first sign of a more serious systemic disease, it is important to determine the etiology for appropriate patient management. [eyewiki.aao.org]
Epidemiology
Cases were identified through the Rochester Epidemiology Project. Three controls chosen from the cataract surgery cohort were matched to each IOL dislocation case by age, gender, and duration of follow-up. [ncbi.nlm.nih.gov]
Epidemiology Frequency United States Clinically insignificant decentration occurs in at least 25% of cases. Clinically significant decentration occurs in about 3% of the cases. The frequency of IOL dislocation ranges from 0.2-1.8%. [emedicine.medscape.com]
Diagnosis: Marfan syndrome with lens dislocation Differential diagnosis for crystalline lens dislocation : Trauma Homocystinuria Sulfite oxidase deficiency Weill-Marchesani Syndrome Hyperlysinemia EPIDEMIOLOGY Incidence: 1/5000 - 1/2000. 60-87% with ectopia [webeye.ophth.uiowa.edu]
Pathophysiology
Pathophysiology IOL dislocation can be subdivided into early and late dislocation. [emedicine.medscape.com]
Prevention
Capsular tension rings probably help but do not prevent this complication. Management includes IOL exchange, replacement with an anterior or a sutured posterior chamber IOL, or suturing the IOL through the bag to the iris or the sclera. [ncbi.nlm.nih.gov]