CASE 10078 Published on 14.05.2012

Traumatic posterior right lens dislocation



Case Type

Clinical Cases


Meriem Zeghidi, Nadida Dali, Lotfi Hendaoui

Radiology department,
Mongi Slim Hospital, La Marsa,
Tunis, Tunisia

82 years, male

Area of Interest Eyes ; Imaging Technique CT, Ultrasound
Clinical History
A 82-year-old man presented complaining of right eye pain with a blurred vision after head trauma.
Imaging Findings
A CT was performed and revealed a posterior dislocation of the right lens (see arrow below). Then, an ocular ultrasound was performed to eliminate other evidence of trauma, such as vitreous haemorrhage, globe rupture or retinal detachment. It showed that the lens was located posteriorly, floating against the retina.
Trauma is the most common cause of acquired lens subluxation-dislocation. Spontaneous atraumatic dislocation is commonly associated with a congenital condition such as Marfan syndrome, homocystinuria, sulfite oxidase deficiency, hyperlysinemia, Elhers-Danlos syndrome, aniridia and congenital glaucoma. Other causes include ocular processes such as staphylomas, ectasias, buphthalmias, high myopia, hypermature cataract and syphilis [1].
With blunt trauma to the anterior globe the anterior-posterior diameter of the globe is suddenly compressed, which increases the coronal diameter causing rupture of the zonular fibres that hold the lens in place. Lens dislocation can be either anterior into the anterior chamber or posterior into the vitreous cavity [2].
Lens dislocation presents with marked visual blurring, monocular diplopia and/or markedly decreased visual acuity in the affected eye.
Dislocation of the lens can be diagnosed by both Computed Tomography (CT) and ultrasound. CT provides a useful adjunct in the assessment of ocular trauma, particularly when the clinical examination is limited. CT images can readily show the displacement of the lens, as well as any associated injuries [3].
Treatment is determined by lens position, with anterior chamber dislocation often being a surgical emergency. As the aqueous humor of the eye flows in the anterior chamber, around the iris from the cilliary body to the canal of Schlemm, this route can become acutely obstructed with anterior dislocation leading to acute glaucoma. The cornea and iris are also at risk for damage. Posterior dislocation may be treated conservatively depending on lens position, but may also lead to uveitis or glaucoma in some cases [4].
Differential Diagnosis List
Traumatic posterior right lens dislocation
Final Diagnosis
Traumatic posterior right lens dislocation
Case information
DOI: 10.1594/EURORAD/CASE.10078
ISSN: 1563-4086