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| CLINICAL IMAGE |
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| Year : 2020 | Volume
: 13
| Issue : 1 | Page : 48 |
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Snowman in the eye
Sonam Yangzes, Simar Rajan Singh, Jagat Ram
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| Date of Submission | 20-Oct-2018 |
| Date of Decision | 31-Oct-2018 |
| Date of Acceptance | 16-Oct-2019 |
| Date of Web Publication | 17-Feb-2020 |
Correspondence Address:
Dr. Jagat Ram
Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh - 160 012
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ojo.OJO_225_2018
How to cite this article:
Yangzes S, Singh SR, Ram J. Snowman in the eye. Oman J Ophthalmol 2020;13:48 |
A 60-year-old female presented with the complaint of decreased vision in the left eye for 3 months following cataract surgery. She was a known case of high myopia and pseudoexfoliation in both eyes and had undergone an uneventful cataract surgery with intraocular lens implantation 3 months ago. Her aided visual acuity at presentation was 6/18 in the left eye. The right eye had significant cataract (aided visual acuity 6/18) and the left eye was pseudophakic with the presence of radial folds in the capsular bag and anterior capsular phimosis [Figure 1]. Anterior capsular phimosis is centripetal fibrosis and contraction of anterior capsule, often associated with a small capsulorhexis, chronic intraocular inflammation, pseudoexfoliation, diabetes mellitus, myotonic muscular dystrophy, and retinitis pigmentosa.[1],[2],[3],[4],[5] The patient underwent surgical capsulotomy and gained 6/9 vision on the last follow-up. | Figure 1: Anterior segment photograph in diffuse illumination (a) and retro-illumination (b) showing contraction of the anterior capsulorhexis margin, giving the appearance of a snowman. The visual axis is obscured, with radiating folds in the anterior capsule extending to the equator
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 Conclusion | |  |
Anterior capsular phimosis is a late complication of cataract surgery which can lead to significant decrease in final visual acuity. One must identify the risk factors associated with this condition and avoid making small capsulorhexis to prevent such complication.
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Davison JA. Capsule contraction syndrome. J Cataract Refract Surg 1993;19:582-9.  |
| 2. | Joo CK, Shin JA, Kim JH. Capsular opening contraction after continuous curvilinear capsulorhexis and intraocular lens implantation. J Cataract Refract Surg 1996;22:585-90. |
| 3. | Hayashi H, Hayashi K, Nakao F, Hayashi F. Area reduction in the anterior capsule opening in eyes of diabetes mellitus patients. J Cataract Refract Surg 1998;24:1105-10. |
| 4. | Hayashi K, Hayashi H, Matsuo K, Nakao F, Hayashi F. Anterior capsule contraction and intraocular lens dislocation after implant surgery in eyes with retinitis pigmentosa. Ophthalmology 1998;105:1239-43. |
| 5. | Hayashi H, Hayashi K, Nakao F, Hayashi F. Anterior capsule contraction and intraocular lens dislocation in eyes with pseudoexfoliation syndrome. Br J Ophthalmol 1998;82:1429-32. |
[Figure 1]
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