|Year : 1979 | Volume
| Issue : 1 | Page : 29-30
Wandering incomplete Soemmerring's ring
HS Chundawat, MK Punjabi
Department of Ophthalmology, S.M.S. Medical College and Hospital, Jaipur, India
H S Chundawat
Department of Ophthalmology, S.M.S. Medical College and Hospital, Jaipur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Chundawat H S, Punjabi M K. Wandering incomplete Soemmerring's ring. Indian J Ophthalmol 1979;27:29-30
In the past one and a half century since the dawn of knowledge of Soemmerring's ring world literature has received only fifteen reports of dislocated Soemmerring's ring and of them less than one third have been operated,. The case described here demands reporting because of certain unusual features.
| Case Report|| |
Mr. M.L., 60 years, advocate, injured his left eye while playing with an arrow at the age of 7 years. He had marked redness, pain, photophobia and diminution of vision in the traumatized eye. His father a medical practitioner gave first aid to which the patient responded but defective vision persisted. He was operated for traumatic cataract after 2 years. He rarely used spectacles. Since then till Oct. 1977 this eye remained quiet. One morning while shaving, he noticed a white crescenic opacity at the upper limbus in the left eye. He consulted his family physician who persumed it to be a foreign body or an intraocular worm And prescribed some local drops and ointment. This opacity disappeared within a day but patient frequently noticed a black spot of variable size obstructing his vision. On 22nd May, 1978 he again noticed the same crescenic opacity along the lower limbus [Figure - 1] and was finally came to Eye O.P.D. of S M.S. Hospital, Jaipur on 15th June, 1978.
On reviewing the history and local examination it appeared to be lenticular matter. Fundus was aphakic and within normal limits. Visual acuity on aphakic correction was 6/12 part. This opacity was lying in the anterior chamber in the lower angle but was not static. The eye was otherwise quiet. Biomicroscopy showed lens capsule with inrolled margins towards the centre and thick opaque lens matter in between. Diagnosis of "Wandering incomplete Soemmerring's ring" was confirmed. After completing routine investigations with small limbal (2 to 4 O'clock) incision it was taken out in pieces because of its fragility without any difficulty. Wound was closed by two interrupted 10/0 virgin silk sutures. Post operative recovery with routine treatment was short and uneventful The patient was discharged with corrected 6112 vision in the affected eye.
| Comments|| |
Formation of after cataract is not an uncommon feature,, and follows extracapsular cataract extraction or trauma, also it rarely occurs after Fukala's operation. Remanants of lens matter may be capsular or capsulolenticular and these capsular folds enclose lens matter to form a ring first described by Soemmerring-a type of after cataract. Absence of nucleus and placement in the retro-iridal space are its characteristic features. Usually these rings are complete and formed at an early age, and do not get dislocated,. Responsible factors for its dislocation are: formation of ring at an early age, myopic degeneration, senile degeneration, trauma, and degenerative changes in the ring itself. It may dislocate in the vitreous or may remain in papillary area , subcausing visual disturbances or in the anterior chamber, leading to inflammation and secondary glaucoma. In this particular case dislocation was spontaneous, ring was incomplete, wandering and its removal was undertaken mainly for cosmetic purposes.
This form of after cataract is not visible normally and remains asymptomatic. Its presentation is so classical that only "Life-Buoy" or disc shaped congenital cataract can be confused with it.
Ours is 5th case, who has undergone surgery, mainly for cosmetic purposes. Out of 11 cases reviewed by Guha, eight had high myopia where as the case reported here had aphakic hyper-metropia with good corrected visual acuity.
| Summary|| |
A case of wandering incomplete Soemmering's ring in anterior chamber, managed surgically for cosmetic reasons.
| Acknowledgement|| |
Authors express thanks to Dr R.G. Sharma and Dr. Y.C. Mishra for their kind guidance.
| References|| |
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[Figure - 1]