Phacomorphic Angle Closure and Anterior Lens Dislocation due to Repeated Blunt Trauma
Contributor: Lauren E. Hock, MD and A. Tim Johnson, MD, PhD
Photographer: Sarah Skiles
Posted September 5, 2018
This 46-year-old female patient had a history of repeated self-induced blunt force trauma to both eyes. She initially presented with anterior lens dislocation with pupillary block in her right eye (Figure 1). She then presented seven months later in angle closure and with a mature cataract in her left eye (OS). Blunt trauma causes abrupt anteroposterior shortening and resultant equatorial stretching that may lead to zonular rupture and lens dislocation . Phacomorphic angle closure may occur when a mature cataract pushes the iris forward, which is demonstrated on her anterior segment optical coherence tomography (Figure 2). Her lens thickness (LT) OS was 5.36 mm; the average LT for patients between 36 and 50 years is 4.05 ± 0.20 mm . Lensectomy is the definitive treatment for both phacomorphic angle closure and pupillary block secondary to lens dislocation.
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