This 51YO female presented with a 6-month history of vision loss in her right eye. She remembered falling 7 months earlier, then woke a few weeks later with severe unilateral vision loss. Vision was counting fingers from a total dislocation of her crystalline lens into the inferior vitreous.
Vitrectomy surgery to remove the dislocated cataract, along with placement of an anterior chamber intraocular lens, was performed, resulting in a return to 20/30 vision.
Learning Points:
Posterior dislocation of the crystalline lens can be caused by trauma or by systemic disorders such as Marfan syndrome, homocystinuria, or Weill-Marchesani syndrome. Pars plana vitrectomy is needed for a completely dislocated lens, as in this patient, whereas subluxed lenses may be managed with phacoemulsification or other means.
