A 34-year-old highly myopic (-9.50 D OD) patient presented with presumed traumatic subluxation of the phakic lens in the right eye. The patient denied prior ocular trauma; however, clinical findings raised a strong suspicion for occult remote trauma. Slit lamp examination demonstrated superonasal lens subluxation with at least 180 degrees of absent zonular support. The lens contour was not truncated, arguing against a congenital lens coloboma. Additionally, focal inferotemporal iridodonesis was present in the area of zonular loss, which is atypical for coloboma. Trace phacodonesis was noted. The iris was slightly ovoid toward 1:30 without transillumination defects. A 2+ superonasal posterior subcapsular cataract and epicapsular stars were observed. Findings are most consistent with traumatic superonasal subluxation of the crystalline lens in a high myope with significant zonular dialysis and associated cataract.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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