Cataracts and Intraocular Lenses

Black Cataract A patient with no past ocular history presented with painless vision loss to HM in the left eye over last 6 weeks. The patient had poor, chronically declining visual acuity in that eye for years but did not have access to care. Slit lamp exam was notable for a dense, black cataract i…

A 6-week old patient presented with persistent fetal vasculature leading to a loss of red reflex due to a congenital cataract. UBM showed an anteriorly rotated ciliary body with a thickened retrolental membrane and a spherically shaped lens. Ultrasound showed a membrane from the optic disc with red…

Elevated Intraocular Pressure After Phakic Posterior Chamber Intraocular Lens Placement A patient with a history of high myopia and contact lens intolerance underwent uncomplicated placement of phakic posterior chamber intraocular lenses in both eyes. She was started on a postoperative tapering cou…

Ocular Cicatricial Pemphigoid A patient with a past medical history significant for biopsy-proven ocular cicatricial pemphigoid (OCP) was referred for cataract evaluation in the right eye. At presentation, her vision in the right eye was hand motion, and she had been off systemic immunosuppression …

Iris cyst

Intraoperative Fluid Deviation Syndrome A patient underwent routine cataract surgery one month after uncomplicated cataract extraction and intraocular lens implantation of the contralateral eye. Intraoperatively, during the hydrodissection step of cataract extraction, the anterior chamber shallowed…

Post RK Hyperopia A patient with a history of 16-cut radial keratotomy presented with significant hyperopia, an epiretinal membrane, and cataract in the right eye. Corneal topography was notable for significant central flattening and irregular astigmatism in both eyes. He underwent cataract surgery…

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.

Bilateral Dense White Cataracts This is a patient with significant complex medical history who presented with hand motion vision secondary to bilateral dense white cataracts. Due to high anesthesia risk given the severity of medial comorbidities including an implanted left ventricular assist device…

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…