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 Table of Contents    
CLINICAL QUIZ
Year : 2023  |  Volume : 16  |  Issue : 1  |  Page : 195-196  

Nontraumatic bilateral inferior ectopia lentis


Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield University Hospitals NHS Foundation Trust, Sheffield, United Kingdom

Date of Submission15-Dec-2019
Date of Acceptance12-Mar-2022
Date of Web Publication21-Feb-2023

Correspondence Address:
Piergiacomo Grassi
Senior Lecturer, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Oxford Road, Manchester, M13 9PL; Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield University Hospitals NHS Foundation Trust, Glossop Road, Sheffield, S10 2JF
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ojo.ojo_278_2019

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How to cite this article:
Grassi P, Ramkissoon Y. Nontraumatic bilateral inferior ectopia lentis. Oman J Ophthalmol 2023;16:195-6

How to cite this URL:
Grassi P, Ramkissoon Y. Nontraumatic bilateral inferior ectopia lentis. Oman J Ophthalmol [serial online] 2023 [cited 2023 Mar 26];16:195-6. Available from: https://www.ojoonline.org/text.asp?2023/16/1/195/370043



An11-year-old myopic boy with left esotropia and amblyopia and no previous ocular and head trauma presented with deteriorating vision and bilateral lens subluxation causing index myopia and astigmatism. His right best-corrected visual acuity (BCVA) had declined from 6/12 to 6/18 (spherical equivalent [SE] −10.75 D), and left BCVA remained 6/36 (SE −9.00 D). Examination showed bilateral marked phacodonesis of crystalline lenses subluxed inferiorly [Figure 1] and [Figure 2]. Bilateral vitreolensectomies were performed with postoperative aphakia and contact lenses (CLs) correction, with a recovery of BCVA to 6/7.5 right (SE +13.00) and final left VA 6/50 (SE +12.50) at 1 year. Systemic workup showed mild learning disabilities only.
Figure 1: Right eye anterior segment photographs showing marked phacodonesis of right crystalline lens dislocated inferiorly

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Figure 2: Left eye anterior segment photographs showing marked phacodonesis of left crystalline lens dislocated inferiorly

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   Questions Top


  1. What is the most likely diagnosis based on history, examination, and systemic findings?
  2. What systemic and ocular disorders need to be considered in the differential diagnosis?
  3. What are the management options?




Click here to view answer. View Answer




 
   References Top

1.
Grassi P, Mudhar HS, Cornish KS. Traumatic suprachoroidal dislocation of crystalline lens. Ophthalmol Retina 2020;4:856-8.  Back to cited text no. 1
    
2.
Kaliaperumal S, Kumar KP, Bhuvaneshwari. Varied phenotypic presentations of homocystinuria in two siblings. Indian J Ophthalmol 2014;62:93-4.  Back to cited text no. 2
[PUBMED]  [Full text]  
3.
Grassi P, Melville S, Hariprasad AS, Winder S, Ramkissoon Y, Spiteri-Cornish K, et al. Structural and functional macular changes after retinectomy for retinal detachment complicated by proliferative vitreoretinopathy. Retina 2021;41:2531-9.  Back to cited text no. 3
    
4.
Foo E, Grassi P, Spiteri-Cornish K. Early vitrectomy in eyes with non-diabetic vitreous hemorrhage. Ther Adv Ophthalmol 2022;14:25158414221090099. doi:10.1177/25158414221090099.  Back to cited text no. 4
    
5.
Romano MR, Cennamo G, Grassi P, Sparnelli F, Allegrini D, Cennamo G. Changes in macular pigment optical density after membrane peeling. PLoS One 2018;13:e0197034.  Back to cited text no. 5
    
6.
Low S, Mohamed R, Davidson A, Papadopoulos M, Grassi P, Webster AR, et al. A new paradigm for delivering personalised care: integrating genetics with surgical interventions in BEST1 mutations. Eye (Lond) 2020;34:577-83.  Back to cited text no. 6
    
7.
Grassi P, Chawla A, Rundle P. Vitrectomy for vitreous hemorrhage from vitreous operculum over retinocytoma. Ophthalmol Retina 2019;3:1055.  Back to cited text no. 7
    
8.
Grassi P. Photodynamic therapy for vasoproliferative tumour associated with retinitis pigmentosa and Usher syndrome type 2. Clin Exp Optom 2022;105:91-3.  Back to cited text no. 8
    
9.
Grassi P, Alexander P. Spontaneous resolution of serous macular detachment and outer retinal defect in optic disc pit maculopathy. Clin Exp Optom 2020;103:384-5.  Back to cited text no. 9
    
10.
Grassi P, Wang H, Spiteri-Cornish K, Chawla A, Ramkissoon Y, Subramani S, et al. The effect of COVID-19 on the vitreoretinal service of a tertiary referral centre: Real-world experience from the Royal Hallamshire Hospital. Eur J Ophthalmol 2022;32:NP335-NP338.doi:10.1177/11206721211049717.  Back to cited text no. 10
    
11.
Català-Mora J, Cuadras D, Díaz-Cascajosa J, Castany-Aregall M, Prat-Bartomeu J, García-Arumí J. Anterior iris-claw intraocular lens implantation for the management of nontraumatic ectopia lentis: Long-term outcomes in a paediatric cohort. Acta Ophthalmol 2017;95:170-4.  Back to cited text no. 11
    
12.
Faria MY, Ferreira N, Neto E. Retropupillary iris-claw intraocular lens in ectopia lentis in Marfan syndrome. Int Med Case Rep J 2016;9:149-53.  Back to cited text no. 12
    
13.
Al Somali AI, Al-Dossari FN, Emara KE, Al Habash A. Outcomes of scleral-fixated intraocular-lens in children with idiopathic ectopia lentis. Middle East Afr J Ophthalmol 2017;24:167-70.  Back to cited text no. 13
    
14.
Byrd JM, Young MP, Liu W, Zhang Y, Tate DB, Crandall AS, et al. Long-term outcomes for pediatric patients having transscleral fixation of the capsular bag with intraocular lens for ectopia lentis. J Cataract Refract Surg 2018;44:603-9.  Back to cited text no. 14
    


    Figures

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