Key Clinical Message
Traumatic crystallin lens dislocation is a common complication following open globe injuries. Wound repair, lensectomy, and prophylactic antibiotic administration are essentials in the management.
Keywords: crystallin lens dislocation, ocular trauma, open globe injury
1. IMAGE DESCRIPTION
A 75‐year‐old man with a history of ocular blunt trauma of the right eye (RE) 2 days ago was referred to our clinic with visual loss and pain. In the ophthalmic examination, we found traumatic scleral rupture and subconjunctival crystallin lens dislocation (Figure 1, upper row). The best corrected visual acuity (BCVA) was hand motion detection for the RE and 20/20 for the left eye (LE). The relative afferent pupillary defect (RAPD) was negative. Fundus examination and intraocular pressure revealed no significant abnormalities in the left eye. The patient underwent surgical repair of the scleral wound, crystallin lens extraction, and wound vitrectomy (Figure 1, lower row). The best corrected visual acuity was 3/10 2 weeks after the primary repair surgery. The patient is a candidate for iridoplasty and secondary intraocular lens implementation.
FIGURE 1.
Open globe injury with crystallin lens dislocation to the subconjunctival space.
2. DISCUSSION
Open globe injuries (OGI) are defined as full‐thickness defects of the eyewall and are among the major public health problems in developing countries. 1 Regarding the severity of the injury, a wide range of complications could lead to permanent vision loss. Traumatic optic neuropathy, traumatic maculopathy, choroidal rupture, and retinal detachment are common causes of blindness following OGI. 2 Depending on the mechanism of injury, traumatic open globe injuries are classified as globe rupture and laceration (Figure 2). Globe rupture occurs following blunt trauma to the eye wall, while lacerations are due to sharp trauma.
FIGURE 2.
OGI classification.
2.1. Clinical approach for a patient with OGI
We summarized the management approach for a patient with OGI in Figure 3. 3
FIGURE 3.
Clinical management for a patient with OGI.
AUTHOR CONTRIBUTIONS
Mehrdad Motamed Shariati: Conceptualization; investigation; project administration; supervision; writing – original draft; writing – review and editing. Seyedeh Maryam Hosseini: Data curation; supervision; writing – review and editing. Zeinab Hashemi Javaheri: Data curation; investigation.
FUNDING INFORMATION
The authors received no funding.
CONFLICT OF INTEREST STATEMENT
The authors declare that they have no competing interests.
CONSENT
Written informed consent was obtained from the patient for the publication of this clinical image report.
Motamed Shariati M, Hosseini SM, Hashemi Javaheri Z. Traumatic subconjunctival lens dislocation. Clin Case Rep. 2023;11:e8098. doi: 10.1002/ccr3.8098
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
REFERENCES
- 1. Okamoto Y, Morikawa S, Okamoto F, et al. Clinical characteristics and outcomes of open globe injuries in Japan. Jpn J Ophthalmol. 2019;63:109‐118. [DOI] [PubMed] [Google Scholar]
- 2. Al‐Mahdi HS, Bener A, Hashim SP. Clinical pattern of pediatric ocular trauma in fast developing country. Int Emerg Nurs. 2011;19(4):186‐191. [DOI] [PubMed] [Google Scholar]
- 3. Chen H, Han J, Zhang X, Jin X. Clinical analysis of adult severe open‐globe injuries in Central China. Front Med. 2021;8:755158. [DOI] [PMC free article] [PubMed] [Google Scholar]
Associated Data
This section collects any data citations, data availability statements, or supplementary materials included in this article.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.