Correspondence

Dislocation of the Lenses

N Engl J Med 2004; 351:1913-1914October 28, 2004

Article

To the Editor:

Mathur and Grodinsky, in Images in Clinical Medicine (June 10 issue),1 present a case in which bilateral dislocation of the intraocular lenses was examined by computed tomography (CT). We appreciate the images of this traumatic finding. However, as a technique for the identification of a lens luxation, CT is of minor importance. First, a slit-lamp examination is mandatory to examine the anterior segment of the eye. This simple ophthalmic technique is inexpensive and gives precise information regarding partial luxation (subluxation) as opposed to complete luxation (dislocation) of the lens (Figure 1Figure 1Image of the Fundus Obtained by Slit-Lamp Examination with the Use of a Three-Mirror Contact Lens.), which was misdiagnosed in this case. Second, if the view is obscured by intraocular bleeding, an ultrasound examination should be performed to determine the location of the lens, since the resolution of ophthalmic ultrasonography is five times that of CT. Third, other causes of blurred vision, such as occlusion of the central retinal artery, which requires immediate therapy, need to be ruled out by funduscopy.

CT is helpful to localize and diagnose other ocular problems and diseases, such as orbital or scleral ruptures, solid tumors, and the presence of foreign bodies. However, positioning the patient on his or her back during CT can influence the location of the floating lens, possibly leading to misinterpretation.

Stefan Mennel, M.D.
Carsten H. Meyer, M.D.
Peter Kroll, M.D.
Philipps University Marburg, 35037 Marburg, Germany
stefan.mennel@lycos.com

1 References

1. 1

   Mathur SK, Grodinsky D. Dislocation of the lenses. N Engl J Med 2004;350:e22-e22
   Full Text | Web of Science | Medline

Citing Articles (1)

Citing Articles

1. 1

   C. H. Meyer, N. Eter, S. Mennel, P. Kroll. (2007) Stumpfe Bulbustraumata am hinteren Pol in der optischen Kohärenz-Tomographie und Fluoreszenz-Angiographie. Spektrum der Augenheilkunde 21:1, 49-61
   CrossRef