|Year : 1974 | Volume
| Issue : 1 | Page : 33-34
Cholesterol crystals and pseudo-hypopyon in anterior chamber
DN Gangwar, K Nath
Gandhi Eye Hospital and A.M.U Institute of Ophthalmology, Aligarh, India
D N Gangwar
Postgraduate Institute of Medical Education and Research, Chandigarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gangwar D N, Nath K. Cholesterol crystals and pseudo-hypopyon in anterior chamber. Indian J Ophthalmol 1974;22:33-4
|How to cite this URL:|
Gangwar D N, Nath K. Cholesterol crystals and pseudo-hypopyon in anterior chamber. Indian J Ophthalmol [serial online] 1974 [cited 2020 Jun 1];22:33-4. Available from: http://www.ijo.in/text.asp?1974/22/1/33/31382
The presence of crystals in the anterior chamber was first reported by Parfait-Landran  . As the condition is still very rare, another case of cholesterol crystals forming a pseudohypopyon is being reported here.
| Case Report|| |
M.D.. a female aged 15 years, attended the Gandhi Eye Hospital with a blind right eye following a perforating injury by a spindle at the age of nine years. On examination the palpebral aperture, size and shape of the fight eye ball were normal. The size and shape of the cornea were normal. It had an adherant leucoma in the upper nasal quadrant [Figure - 1] where the anterior surface of the iris from the lower nasal quadrant was adherant and consequently the anterior chamber was irregular. At 6 O'clock there was a deep organized horizontal opacity [Figure - 1]. The direct reaction in this eye and consensual in the other eye were completely absent. Right pupil was slightly larger and dilated very little even after 1% atropine sulphate ointment. The anterior lens capsule was missing while the anterior cortex and the lens nucleus were absorbed. Posterior lens capsule and cortex appeared thickened, organised and showed proliferation of brown uveal pigment at its periphery. The whole thing gave the appearance of a hollow cup facing forward. The fundus of this eye could not be visualised. The tension was slightly low and the eye had no perception to light. The other eye was normal in all respects.
On slit lamp examination the anterior chamber and the hollow in the posterior lens matter were found to be full of transluscent shimmering radiant, floating micro-crystals of variable sizes. They moved with the movement of the eve but not so freely and some of them settled on the iris and below in the anterior chamber like a hypopyon [Figure - 1],[Figure - 2]. Zonules could not be visualised.
The aqueous was removed and centrifuged. The deposits were examined under microscope. A large number of rhomboidal rectangular and envelope like colourless crystals were seen lying either individually or at places in clusters especially near the edge of the cover slip [Figure - 3].
The deposits were washed and tested for the presence of cholesterol by adding chloroform in equal volumes, which gave a purple colour.
Further confirmation was done by formaldehyde sulphuric acid test when to a chloroform solution of crystals, an equal volume of formaldehyde sulphuric acid solution was added, a cherry red colour developed.
On general examination no significant signs were observed.
Other investigations were non-contributory.
| Discussion|| |
Besides thousands of cholesterol crystals, the unusual feature in this case was a deep corneal and endothelial horizontal opacity at 6 O'clock showing thereby that the patient must have suffered from a prolonged hypopyon iritis or iridocyclitis after the injury. This is further evident by the massive proliferation of pigment epithelium over the peripheral portion of the posterior lenticular matter or else the lower horizontal opacity could have been due to the prolonged contact of cholesterol crystals themselves, which is rather unlikely. The anterior lens capsule was missing. There was no vitreous either in the anterior chamber or in front of the organised posterior lens capsule. Such the source of the cholesterol appears to be due to the prolonged interaction of the aqueous with the lens matter itself.
| Summary|| |
A case of massive cholesterol crystals in the anterior chamber following a perforating injury to the cornea and lens by a spindle is reported.
| References|| |
Parfait- Landran 1928, Rev. Med. France., Etrang., 4,
[Figure - 1], [Figure - 2], [Figure - 3]