Dislocation or subluxation of the lens
Introduction
Introduction The crystal is connected to the ciliary body by a suspensory ligament and suspended in the aqueous humor. Due to trauma or surgery caused by rupture of the suspensory ligament, incomplete development of the congenital suspensory ligament or dissolution of the suspensory ligament due to intraocular lesions can cause changes in lens position, which is called crystal dislocation or subluxation.
Cause
Cause
Occasionally, the lens is ectopic due to improper operation or other reasons during surgery, which is a common complication in cataract surgery. The main cause of this, in addition to the anatomical factors of the eye itself, is mainly related to surgical techniques. This condition is more common in phacoemulsification cataract surgery because phacoemulsification is complicated and complicated, and additional fluid mechanics factors often occur suddenly without pre-sensing. Especially when the perfusion balance is out of balance, repeated surges and subversion of the lens often cause the lens ligament to break.
Examine
an examination
Related inspection
Lens examination ophthalmoscopy
The following symptoms and signs can occur with dislocation of the crystal:
1 sudden drop in vision;
2 With the movement of the body, the object has obvious shaking;
3 single eye double vision;
4 the front room is deepened;
5 iris tremor;
6 crystals located in the anterior chamber can cause secondary glaucoma and corneal damage.
1. Ask about the history of trauma, understand and analyze the relationship between the degree of eye injury and lens dislocation.
2. Comprehensive physical examination, paying particular attention to systemic diseases associated with trauma.
3. Visual function detection, such as retinal vision, ERG, VEP, and color vision examination.
4. Comprehensive examination of other eyes, such as eye position, eye movement, intraocular pressure, anterior chamber angle, pupil, iris, rupture of eye wall, dilated pupil, disconnection of iris root, residual vitreous of anterior chamber, retinal detachment, choroid Rupture, bleeding, etc.
5. Record the shape and position of the lens in detail. In patients with incomplete dislocation, the location and extent of the ligament of the lens ligament must be clarified. Patients who are completely in the vitreous must understand whether the lens adheres to the intraocular tissues and understand the relationship between the position of the lens and the change of body position. The lens that is completely dislocated into the anterior chamber must know whether the lens will break into the vitreous body due to changes in body position in the anterior chamber.
6. If the position of the lens in the vitreous cavity cannot be determined due to vitreous opacity, routine ultrasound examination should be performed to understand the activity of the lens in the vitreous cavity by changing the position.
7. For patients with incomplete dislocation, ask if there is any presence of monocular double vision, and examine distal vision, near vision and corrected vision in detail.
Diagnosis
Differential diagnosis
Need to be identified with the following symptoms:
Lens shift: Under normal conditions, the lens is suspended by the lens suspensory ligament on the ciliary body, and its center is almost identical to the visual axis. The partial or total loss or disconnection of the lens suspensory ligament due to congenital, traumatic or pathological causes, etc., causes the suspension force imbalance or loss of the lens to cause the lens to leave the normal physiological position called ectopia lentis. The degree of ligament defect or disconnection (partial or complete) lens ectopic is divided into subluxation and liberation/dislocation; according to the cause of lens ectopic, it is divided into congenital, spontaneous and traumatic. Lens protrusion: lens protrusion is one of the symptoms of myopia.
Corneal lens adhesion: Due to Peter's abnormality, some eyes may have a central corneal lens adhesion, accompanied by a shallow anterior chamber, and some are pre-polar cataracts.
