Lens dislocation - Revision history

Rossdonaldson1: /* Background */

2023-01-18T21:39:30Z

Background

← Older revision		Revision as of 21:39, 18 January 2023
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	==Background==		==Background==
			[[File:Schematic diagram of the human eye en.png\|thumb\|Eye anatomy.]]
	*aka Ectopia Lentis		*aka Ectopia Lentis
	*Dislocation: anterior or posterior displacement of lens due to complete separation of lens zonule fibers		*Dislocation: anterior or posterior displacement of lens due to complete separation of lens zonule fibers

ClaireLewis: /* See Also */

2019-10-05T17:12:36Z

ClaireLewis at 18:08, 28 September 2019

2019-09-28T18:08:14Z

← Older revision		Revision as of 18:08, 28 September 2019
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	*Less commonly due to [[lightening]]/[[electrocution]]		*Less commonly due to [[lightening]]/[[electrocution]]
	*Can occur after minor or no trauma in patients with:		*Can occur after minor or no trauma in patients with:
	**~~Marfans~~		**[[Marfan syndrome]]
	**Homocystinuria		**Homocystinuria
	**~~Ehler's~~ Danlos		**[[Ehlers-Danlos syndrome]]
	**Tertiary ~~syphillis~~		**Tertiary [[syphilis]]
	**Prior cataract surgeries		**Prior cataract surgeries

	==Clinical Features==		==Clinical Features==
	[[File:LensDislocationPic.jpg\|thumb\|Lens dislocation, from tedmontgomery.com]]		[[File:LensDislocationPic.jpg\|thumb\|Lens dislocation, from tedmontgomery.com]]
	*Red, painful eye		*[[red eye\|Red]], [[eye pain\|painful eye]]
	*Diplopia, reduced visual acuity		*[[Diplopia]], [[vision loss\|reduced visual acuity]]
	*Floaters		*[[Floaters]]
	*+/- iris tremor after rapid eye movement		*+/- iris tremor after rapid eye movement
	*Raised intraocular pressure, if aqueous flow blocked		*Raised [[intraocular pressure]], if aqueous flow blocked
	*[[Slit lamp]]: edge of subluxated lense can be seen with dilated pupil		*[[Slit lamp]]: edge of subluxated lense can be seen with dilated pupil

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	*Evaluate for other injuries		*Evaluate for other injuries
	*Slit lamp exam, visual acuity		*Slit lamp exam, visual acuity
	*Ultrasound		*[[ocular ultrasound\|Ultrasound]]
	**Lense displaced from usual position		**Lense displaced from usual position
	**evidence of other associated traumatic injuries		**evidence of other associated traumatic injuries
	*Measure intraocular pressure with [[Tonopen]]		*Measure [[intraocular pressure]] with [[Tonopen]]

	==Management==		==Management==

Mholtz: Text replacement - "-->" to "→"

2017-02-08T18:50:38Z

Text replacement - "-->" to "→"

← Older revision		Revision as of 18:50, 8 February 2017
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	**Subluxation: incomplete disruption of lens zonule fibers		**Subluxation: incomplete disruption of lens zonule fibers
	*[[Acute angle closure glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow		*[[Acute angle closure glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow
	*Lens capsule disruption can cause lens stroma to swell and become ~~cloudy-->~~ acute glaucoma and traumatic cataracts		*Lens capsule disruption can cause lens stroma to swell and become cloudy→ acute glaucoma and traumatic cataracts

	===Causes===		===Causes===

Rossdonaldson1: /* Clinical Features */

2016-09-24T11:27:14Z

Clinical Features

← Older revision		Revision as of 11:27, 24 September 2016
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	*Raised intraocular pressure, if aqueous flow blocked		*Raised intraocular pressure, if aqueous flow blocked
	*[[Slit lamp]]: edge of subluxated lense can be seen with dilated pupil		*[[Slit lamp]]: edge of subluxated lense can be seen with dilated pupil
	*Associated with:
	**[[Vitreous hemorrhage]]		===Associated with===
	**[[Acute angle closure glaucoma]]		*[[Vitreous hemorrhage]]
	**[[Hyphema]]		*[[Acute angle closure glaucoma]]
	**[[Retinal detachment]]		*[[Hyphema]]
	**[[Globe rupture]]		*[[Retinal detachment]]
			*[[Globe rupture]]

	==Differential Diagnosis==		==Differential Diagnosis==
	{{Unilateral red eye DDX}}		{{Unilateral red eye DDX}}

Rossdonaldson1 at 11:26, 24 September 2016

2016-09-24T11:26:54Z

← Older revision		Revision as of 11:26, 24 September 2016
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	==Clinical Features==		==Clinical Features==
			[[File:LensDislocationPic.jpg\|thumb\|Lens dislocation, from tedmontgomery.com]]
	*Red, painful eye		*Red, painful eye
	*Diplopia, reduced visual acuity		*Diplopia, reduced visual acuity
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	*+/- iris tremor after rapid eye movement		*+/- iris tremor after rapid eye movement
	*Raised intraocular pressure, if aqueous flow blocked		*Raised intraocular pressure, if aqueous flow blocked
	*Slit lamp: edge of subluxated lense can be seen with dilated pupil		*[[Slit lamp]]: edge of subluxated lense can be seen with dilated pupil
	*Associated with:		*Associated with:
	**[[Vitreous hemorrhage]]		**[[Vitreous hemorrhage]]
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	**[[Retinal detachment]]		**[[Retinal detachment]]
	**[[Globe rupture]]		**[[Globe rupture]]
	~~[[File:LensDislocationPic.jpg\|thumb\|Lens dislocation, from tedmontgomery.com]]~~

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Differential Diagnosis */

2016-09-22T22:21:36Z

Differential Diagnosis

← Older revision		Revision as of 22:21, 22 September 2016
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	==Differential Diagnosis==		==Differential Diagnosis==
			{{Unilateral red eye DDX}}

	==Evaluation==		==Evaluation==

Rossdonaldson1: /* Background */

2016-09-22T22:20:57Z

Background

← Older revision		Revision as of 22:20, 22 September 2016
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	*Dislocation: anterior or posterior displacement of lens due to complete separation of lens zonule fibers		*Dislocation: anterior or posterior displacement of lens due to complete separation of lens zonule fibers
	**Subluxation: incomplete disruption of lens zonule fibers		**Subluxation: incomplete disruption of lens zonule fibers
	*Causes:
	**Most commonly due to [[blunt eye trauma]], though less commonly due to lightening/[[electrocution]]
	**Can occur after minor or no trauma in patients with Marfans, homocystinuria, Ehler's Danlos, tertiary syphillis, or prior cataract surgeries
	*[[Acute angle closure glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow		*[[Acute angle closure glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow
	*Lens capsule disruption can cause lens stroma to swell and become cloudy--> acute glaucoma and traumatic cataracts		*Lens capsule disruption can cause lens stroma to swell and become cloudy--> acute glaucoma and traumatic cataracts

			===Causes===
			*Most commonly due to [[blunt eye trauma]]
			*Less commonly due to [[lightening]]/[[electrocution]]
			*Can occur after minor or no trauma in patients with:
			**Marfans
			**Homocystinuria
			**Ehler's Danlos
			**Tertiary syphillis
			**Prior cataract surgeries

	==Clinical Features==		==Clinical Features==

ClaireLewis at 18:44, 8 September 2016

2016-09-08T18:44:03Z

← Older revision		Revision as of 18:44, 8 September 2016
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	**Most commonly due to [[blunt eye trauma]], though less commonly due to lightening/[[electrocution]]		**Most commonly due to [[blunt eye trauma]], though less commonly due to lightening/[[electrocution]]
	**Can occur after minor or no trauma in patients with Marfans, homocystinuria, Ehler's Danlos, tertiary syphillis, or prior cataract surgeries		**Can occur after minor or no trauma in patients with Marfans, homocystinuria, Ehler's Danlos, tertiary syphillis, or prior cataract surgeries
	*[[Acute ~~Angle Glaucoma~~]]: can result when anteriorly displaced lens obstructs aqueous flow		*[[Acute angle closure glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow
	*Lens capsule disruption can cause lens stroma to swell and become cloudy--> acute glaucoma and traumatic cataracts		*Lens capsule disruption can cause lens stroma to swell and become cloudy--> acute glaucoma and traumatic cataracts

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	*Associated with:		*Associated with:
	**[[Vitreous hemorrhage]]		**[[Vitreous hemorrhage]]
	**[[Acute angle glaucoma]]		**[[Acute angle closure glaucoma]]
	**[[Hyphema]]		**[[Hyphema]]
	**[[Retinal detachment]]		**[[Retinal detachment]]
	**[[Globe rupture]]		**[[Globe rupture]]
	[[File:LensDislocationPic.~~jpeg~~\|thumb\|Lens dislocation~~. From~~ tedmontgomery.com]]		[[File:LensDislocationPic.jpg\|thumb\|Lens dislocation, from tedmontgomery.com]]

	==Differential Diagnosis==		==Differential Diagnosis==

	==Evaluation==		==Evaluation==
			[[File:LensDislocation.jpg\|thumb\|Lens dislocation on US, from "Radiology Picture of the Day"]]
	*Evaluate for other injuries		*Evaluate for other injuries
	*Slit lamp exam, visual acuity		*Slit lamp exam, visual acuity
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	**evidence of other associated traumatic injuries		**evidence of other associated traumatic injuries
	*Measure intraocular pressure with [[Tonopen]]		*Measure intraocular pressure with [[Tonopen]]
	~~[[File:LensDislocation.jpg\|thumb\|Lens dislocation on US, from "Radiology Picture of the Day"]]~~
	==Management==		==Management==
	*Optho consult (emergently if elevated IOP!)		*Optho consult (emergently if elevated IOP!)

ClaireLewis at 18:40, 8 September 2016

2016-09-08T18:40:55Z

← Older revision		Revision as of 18:40, 8 September 2016
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	==Background==		==Background==
	~~Lens dislocation~~ or ~~subluxation is any movement~~ of ~~the~~ lens of ~~the eye either anteriorly or posteriorly from its socket attached to the suspensory ligaments. This typically occurs~~ due to blunt trauma ~~to the eye~~, ~~and is~~ commonly ~~seen in conjunction with a~~ [[~~hyphema~~]] ~~and/~~or ~~a [[vitrious hemorrhage]]. There are conditions that predispose~~ patients ~~to lens dislocations from even minor traumatic events~~, ~~such as~~ [[~~Marfans syndrome~~]] ~~(classically~~ lens ~~is upwards and outwards), [[Homocystinuria]] (classically~~ lens ~~is downwards and inwards),~~ and ~~Ehlers–Danlos syndrome. A emergent complication of a lens dislocation is~~ acute ~~angle closure~~ glaucoma, and ~~occurs because of disruption of the iris and the cornea.~~		*aka Ectopia Lentis
			*Dislocation: anterior or posterior displacement of lens due to complete separation of lens zonule fibers
			**Subluxation: incomplete disruption of lens zonule fibers
			*Causes:
			**Most commonly due to [[blunt eye trauma]], though less commonly due to lightening/[[electrocution]]
			**Can occur after minor or no trauma in patients with Marfans, homocystinuria, Ehler's Danlos, tertiary syphillis, or prior cataract surgeries
			*[[Acute Angle Glaucoma]]: can result when anteriorly displaced lens obstructs aqueous flow
			*Lens capsule disruption can cause lens stroma to swell and become cloudy--> acute glaucoma and traumatic cataracts

	==Clinical Features==		==Clinical Features==
			*Red, painful eye
			*Diplopia, reduced visual acuity
			*Floaters
			*+/- iris tremor after rapid eye movement
			*Raised intraocular pressure, if aqueous flow blocked
			*Slit lamp: edge of subluxated lense can be seen with dilated pupil
			*Associated with:
			**[[Vitreous hemorrhage]]
			**[[Acute angle glaucoma]]
			**[[Hyphema]]
			**[[Retinal detachment]]
			**[[Globe rupture]]
			[[File:LensDislocationPic.jpeg\|thumb\|Lens dislocation. From tedmontgomery.com]]

	==Differential Diagnosis==		==Differential Diagnosis==


	==Evaluation==		==Evaluation==
			*Evaluate for other injuries
			*Slit lamp exam, visual acuity
			*Ultrasound
			**Lense displaced from usual position
			**evidence of other associated traumatic injuries
			*Measure intraocular pressure with [[Tonopen]]
			[[File:LensDislocation.jpg\|thumb\|Lens dislocation on US, from "Radiology Picture of the Day"]]
	==Management==		==Management==
			*Optho consult (emergently if elevated IOP!)
			*Optho will either repair surgically or observe, depending on displacement and associated injuries/symptoms

	==Disposition==		==Disposition==


	==See Also==		==See Also==
			*[[Blunt orbital trauma]]
			*[[Vitreous hemorrhage]]
			*[[Acute angle glaucoma]]
			*[[Hyphema]]
			*[[Retinal detachment]]
			*[[Globe rupture]]

	==External Links==		==External Links==
			*Video of slit lamp exam of dislocated lens: http://www.rootatlas.com/wordpress/video/579/lens-subluxation-with-vitreous-video/

	==References==		==References==

← Older revision		Revision as of 17:12, 5 October 2019
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	*[[Blunt orbital trauma]]		*[[Blunt orbital trauma]]
	*[[Vitreous hemorrhage]]		*[[Vitreous hemorrhage]]
	*[[Acute angle glaucoma]]		*[[Acute angle closure glaucoma]]
	*[[Hyphema]]		*[[Hyphema]]
	*[[Retinal detachment]]		*[[Retinal detachment]]