Cataracts and Intraocular Lenses

An otherwise asymptomatic 82-year-old patient with uncorrected visual acuity of 20/25 at distance presents for a routine eye exam in clinic.

Achromobacter Xylosoxidans Endophthalmitis A 79-year-old male with history of Fuchs endothelial dystrophy of both eyes s/p penetrating keratoplasty of both eyes (1980s), repeat penetrating keratoplasty of left eye (2018) and regmatogenous retinal detachment of left eye s/p repair with silicon oil w…

A well-positioned ACIOL with superior nasal iridotomy.

Traumatic anterior dislocation of crystalline lens with Descemet’s folds in the cornea. The patient was treated with lensectomy and vitrectomy. Due to the high myopia, there was no need for secondary intraocular lens or contact lens. The final vision uncorrected visual acuity was 20/30 aphakic.

Cataract Associated with Ciliary Body Melanoma A patient with recently diagnosed ciliary body melanoma was referred to the BPEI glaucoma service for cataract evaluation. Examination revealed CF vision, a dense white cataract, and ciliary body melanoma that had extended into the iris. The patient ha…

Cataracts and Radial Keratotomy A 69-year-old male presented to Bascom Palmer Eye Institute for glare and blurry vision in both eyes. Exam revealed 20/70 vision in right eye and 20/60 in left eye. Patient had 8 RK incision in both eyes and 2+ NS in both eyes. Patient's preoperative evaluation inclu…

The multicolored appearance is due to needle shaped polychromatic peptide crystals in the cortex or nucleus of the lens. These are not generally visually significant.

Dislocated Intraocular Lens A 74-year-old male presented to the BPEI ER with blurred vision in the right eye for 3 days. He underwent cataract surgery in both eyes 9 years prior in Costa Rica. He denied any other prior ocular history or trauma. Exam revealed VA 20/200+1 in the right eye. IOP was wi…

B-scan ultrasound shows a well circumscribed mass inferiorly with focal hyper-densities. This can mimic a tumor, but the patient has a history of trauma and the object in question is a dislocated crystalline lens.

Epithelial Downgrowth This case presents a 56-year-old female who presented with dramatic decrease of vision over a one-year duration. Patient has previously undergone both eyes corneal transplant, glaucoma drainage device. Patient developed right eye iris cyst, that started growing occupying the a…

Isolated Spherophakia A patient with ocular hypertension and narrow angle was found to have Isolated Spherophakia. She underwent phacoemulsification with a capsular tension ring and intraocular lens in the bag OS. She then had a pars plana vitrectomy with a scleral fixated lens OD. Post-operatively…

In this module, we will look at:




Anatomy of the Lens


Cataracts