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   Table of Contents      
CASE REPORT
Year : 1985  |  Volume : 33  |  Issue : 1  |  Page : 51-52

Anterior dislocation of the pyramidal part of a congenital cataract


Department of Ophthalmology, Christian Medical College, Vellore, India

Correspondence Address:
Ravi Thomas
Department of Ophthalmology, C.M.C. Vellore 632 001
India
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Source of Support: None, Conflict of Interest: None


PMID: 3878332

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How to cite this article:
Thomas R, Santhan Gopal K S, George JA. Anterior dislocation of the pyramidal part of a congenital cataract. Indian J Ophthalmol 1985;33:51-2

How to cite this URL:
Thomas R, Santhan Gopal K S, George JA. Anterior dislocation of the pyramidal part of a congenital cataract. Indian J Ophthalmol [serial online] 1985 [cited 2019 Aug 23];33:51-2. Available from: http://www.ijo.in/text.asp?1985/33/1/51/27333

Opacities at the anterior pole of the lens are relatively common. They may occur as congenital defects or postnatally as a sequel to ulceration of the cornea.

These cataracts may assume a pyramidal from projecting into the anterior chamber. The opacity usually extends backwards into the lens, but a clear area may separate the pyramid from the lenticular opacity-the reduplicated cataract. Such cases are usually bilateral and symmetrical[1].

We are reporting a case of dislocation of the pyramidal part of a reduplicated cataract into the anterior chamber.


  Case report Top


Mr. M. 30 year old male presented to us with complaints of gradual diminution of vision both eyes for five years and watering from the left eye for one year. He was not aware of any diminution of vision, prior to this and gave no history of trauma to the eyes or any inflammatory symptoms in the past.

On examination vision was 6/18 O.D. and hand movement close to face O.S. with an accurate projection of light. The right eye had a pyramidal cataract and blue dot opacities of the lens [Figure - 1] The left eye had an exotropia of 15° and did not take up fixation. Pressure over the sac on this side revealed regurgitation of mucopus.

There was a rounded white opaque mass about 3 mm x 4 mm lying in the bottom of the anterior chamber which was otherwise clear [Figure - 2]. There was a spot of brown pigment on the anterior surface of this mass. The superficial aspect of the lens was clear but there was an imprint opacity in the cortex and a la mellar cataract.

The media were very hazy in left eye due to the lens changes, but indirect ophthalmoscopy showed an atrophic lesion in the macula with pigmented borders.

The tension in both eyes was 17.3 mmHg (Schiotz). Retinoscopy could not be done in the left eye. The vision in right eye failed to improve with refraction (+3.5 D. sph). The patient was advised to come for investiga­tion and a dacryocystorhinostomy for the left eye, but failed to keep his appointment.


  Discussion Top


Although dislocation of the lens cr nucleus into anterior chamber is a common enough clinical presentation, we have never seen a case of dislocation of the pyramidal part of an imprint cataract into the anterior chamber, and to the best of our knowledge has not been described before.

In cases of anterior polar cataract causing considerable diminution of vision the cataract has been detached with a knife and subse­quently extracted from the anterior chamber with forceps[2].

In our patient, the dislocation caused no reaction to the eye. We were planning to do a dacryocystorhinostomy and keeping him under regular observation but he did not return for surgery.


  Summary Top


A patient presented to us with complaints of gradual diminution of vision in both the eyes and watering from left eye. He was found to have a pyramidal cataract in the right eye. In the left eye, he had an imprint cataract, the pyramidal portion of which was dislocated into and lying in the bottom of the anterior chamber.

 
  References Top

1.
Duke-Elder, S.. 1964, System of Ophthalmology St. Louis, C.V. Mosby Co. Vol. III Part II, P. 720.  Back to cited text no. 1
    
2.
Selinger, 1932, Arch. Ophthalmol. (Chicago), 7 : 109   Back to cited text no. 2
    


    Figures

  [Figure - 1], [Figure - 2]


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