Intraocular Lens Glistenings
A patient presented with a chief complaint of blurry vision in the left eye that he noticed the day prior while reading. Clinical exam was significant for a sheet of multiple, small crystal-like formations within the left intraocular lens implant. Based on the appearance of the deposits within the lens, a diagnosis of intraocular lens (IOL) glistenings was achieved. IOL glistenings are a common finding in hydrophobic lenses and are often mistaken for posterior capsule opacification. As a result, patients may undergo YAG capsulotomy as an attempt to clear the lens of the glistenings, though this is not the treatment. Glistenings should be observed and only in severe cases be treated with IOL exchange. There is significant debate regarding whether glistenings can cause visual acuity complaints. Some studies demonstrate significant light scatter, specifically with smaller-sized glistenings. Case reports have also demonstrated that individuals significantly improve their visual acuity after lens exchange in cases of extreme glistenings. On the other hand, other studies suggest the contrary and encourage observation instead of surgical intervention. Hydrophobic lenses are the most common kind of lens associated with this finding. They also carry a higher risk of subsurface nanoglistenings compared to other kinds of lenses. However, the rate of posterior capsule opacification is lower with this type of lens. Ultimately, the patient was lost to follow up, though based on his clinical photos, there is a high suspicion that his glistenings accounted for at least some of his poor visual acuity.
Presentation Date: 05/07/2026
Issue Date: 05/08/2026
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