Lens Dislocation

- CE credits 2 hours
- COPE code 58572-AS / 116191
- Available until Jul 26, 2021
- $29

Introduction

Learning Objectives

To review the etiologies of ectopia lentis
To review management options for cataract extraction in ectopia lentis
To review type 1 and type 2 errors

Case

A 34-year-old male presents to the emergency department following a motor vehicle accident in which he struck a light post at low speed. He was belted and the airbag was activated. There was no loss of consciousness or significant systemic injuries, however he complains of decreased vision and monocular diplopia in the right eye. His past medical and ocular history is otherwise unremarkable.

The patient says the symptoms started soon after the incident, and he feels that the airbag impact was maximal over his right eye. On exam, visual acuity is 20/100 and 20/20 in the right and left eyes, respectively. Posterior segment exam is shown below:

Quick Question

While likely not present in this individual, what is the most common genetic cause of the abnormality causing this patient’s symptoms?

Pseudoexfoliation syndrome

Pseudoexfoliation syndrome is an elastic microfibrillopathy characterized by fibrillogranular material found in the anterior segment. Although certainly associated with ectopia lentis, it is not the most common cause.
Marfan syndrome

CORRECT
Ehlers-Danlos syndrome

Ehlers-Danlos syndrome is a group of connective tissue disorders characterized by a defect in the synthesis of collagen. It is a relatively common disorder and only very rarely causes ectopia lentis.
Myopia

Myopia is not the most common genetic cause of ectopia lentis

Introduction

Ectopia lentis is a partial or complete displacement of the crystalline lens from its central position in the pupil, caused by broken or weakened zonules.¹ It is most commonly caused by trauma, although it is also associated with many systemic conditions, including most commonly Marfan syndrome.² Nontraumatic ectopia lentis occurs at an estimated prevalence of 6.4 per 100 000 and affects both males and females at an equal rate.³

Next: Disease Review