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OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 11  |  Page : 1881

Direct view of ciliary processes associated with severe subluxation of crystalline lens


1 Department of Vitreo-Retina, Aravind Eye Hospital, Madurai, Tamil Nadu, India
2 Department of Cornea, Aravind Eye Hospital, Madurai, Tamil Nadu, India

Date of Web Publication22-Oct-2019

Correspondence Address:
Dr. Chitaranjan Mishra
Department of Vitreo-Retinal Services, Aravind Eye Hospital, Anna Nagar, Madurai - 625 020, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1004_19

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How to cite this article:
Mishra C, Ramasamy K, Rai P. Direct view of ciliary processes associated with severe subluxation of crystalline lens. Indian J Ophthalmol 2019;67:1881

How to cite this URL:
Mishra C, Ramasamy K, Rai P. Direct view of ciliary processes associated with severe subluxation of crystalline lens. Indian J Ophthalmol [serial online] 2019 [cited 2019 Nov 18];67:1881. Available from: http://www.ijo.in/text.asp?2019/67/11/1881/269596



A 23-year-old patient presented with decreased vision in both the eyes (BE). His Best corrected visual acuity in right eye (RE) was 5/60 and in the left eye (LE) was 1/60. Anterior segment examination revealed severe subluxation of crystalline lens with the lens edge uncovering greater than 50% of the pupil in BE.[1] The RE had additional findings of direct view of ciliary processes on slit lamp examination; probably as a result of stretched lens zonules causing traction on the ciliary processes [Figure 1]a and [Figure 1]b. Intraocular pressure was 16 mm Hg in BE. Fundus examination revealed retino-choroidal coloboma involving disc and macula in BE. Pars plana vitrectomy with lensectomy is the surgical procedure of choice for severe subluxation of lens and special care should be taken to avoid injury to the ciliary processes.[2] However, surgery was deferred in this case in view of very guarded visual prognosis due to the posterior segment pathology as mentioned. This is the first case report of direct visualisation of ciliary processes on slit lamp examination.
Figure 1: (a) Direct view of ciliary processes temporally on slit lamp examination (white arrow marks). (b) Magnified view of ciliary processes along with attached stretched lens zonules (white arrow marks) and gross subluxation of crystalline lens

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Hoffman RS, Snyder ME, Devgan U, Allen QB, Yeoh R, Braga-Mele R. Management of the subluxated crystalline lens. J Cataract Refract Surg 2013;39:1904-15.  Back to cited text no. 1
    
2.
Mitra S, Ganesh A. Scleral Suspension pars plana lensectomy for ectopia lentis followed by suture fixation of intraocular lens. Indian J Ophthalmol 2001;49:109-13.  Back to cited text no. 2
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