This 67YO male presented with 3 weeks of decreased vision in his right eye. Vision was 20/120 OD with a +10 diopter sphere and 20/30 in his normal OS. Color photography shows a cataractous lens fully dislocated into the inferior vitreous cavity. A shallow macula-off rhegmatogenous retinal detachment is noted in the posterior pole without apparent breaks. Pars plana vitrectomy was performed the following day, which included lens extraction and retinal detachment repair.
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 with this patient, while lenses that are subluxed may be managed with phacoemulsification or other means.
Our patient’s lens spontaneously dislocated with no history of trauma. Pseudoexfoliation was noted on slit lamp examination of her left lens, which may have predisposed her to lens dislocation.
