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Lens dislocation and subluxation: causes, symptoms, diagnosis, treatment

 
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Last reviewed: 23.04.2024
 
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Dislocation of the lens - complete detachment of the lens from the supporting - ligament and displacement of it into the anterior or posterior chamber of the eye. In this case, a sharp decrease in visual acuity occurs, since a lens with a strength of 19.0 D, dropped out of the optical system of the eye. The dislocated lens is to be removed.

A subluxation of the lens is a partial detachment of the zinn ligament, which may have different circumferential extensions.

Congenital dislocations and subluxations of the lens are described above. The acquired bias lens bias occurs as a result of blunt injuries or gross shaking. The clinical manifestations of subluxation of the lens depend on the magnitude of the defect formed. Minimal lesions may go unnoticed if the anterior border membrane of the vitreous humor is not damaged and the lens remains transparent.

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Symptoms of dislocation and subluxation of the lens

The main symptom of subluxation of the lens is the trembling of the iris (iridonas). The delicate iris tissue rests on the lens at the front pole, so the shaking of the subluxed lens is transmitted to the iris. Sometimes this symptom can be seen without using special methods of research. In other cases, you have to carefully monitor the iris with side lighting or in the light of a slit lamp to catch a light wave of movement with small shifts of the eyeball. At sharp leads of an eye to the right and to the left easy or light; mild fluctuations of an iris to reveal it is not possible. It should be noted that iridonodez is not always present even with noticeable subluxations of the lens. This occurs when, along with tearing of the zinn ligament in the same sector, a defect appears in the anterior border membrane of the vitreous. This results in an injured hernia of the vitreous, which tamponizes the hole formed, reduces the lens's mobility. In such cases, the subluxation of the lens can be recognized by two other symptoms detected by biomicroscopy: it is the uneven depth of the anterior and posterior chambers of the eye due to a more pronounced pressure or the movement of the vitreous body anteriorly in the zone of weakening of the lens support. With the restrained and fixed adhesions of the hernia of the vitreous body, the posterior chamber in this sector increases and at the same time the depth of the anterior chamber of the eye changes, most often it becomes smaller. Under normal conditions, the rear camera is not available for inspection, so the depth of its peripheral parts is judged by an indirect indication - a different distance from the edge of the pupil to the lens on the right and left or top and bottom.

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Treatment of dislocation and subluxation of the lens

With uncomplicated subluxation of the lens, visual acuity is not significantly reduced and no treatment is required. However, complications develop over time. The subluxed lens may become cloudy, or it causes the development of secondary glaucoma. In such cases, the question arises of how to remove it. Timely diagnosis of subluxation of the lens allows you to choose the right surgical tactics, evaluate the possibility of strengthening the capsule and placing an artificial lens in it.

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