Lens Injury

Abstract

Any mechanical or physical force that caused the crystalline lens position, stability, clarity, and capsular integrity to change is called lens injury. The mechanical forces include contused cataract, subluxation and dislocation (anteriorly into the anterior chamber or posteriorly into the vitreous cavity), perforation and penetrating injury, and intralenticular foreign bodies (siderosis bulbi, chalcosis, etc.). The physical forces include radiation (ionizing radiation, infrared radiation, ultraviolet radiation, microwave radiation, etc.), chemical injury, and electrical injury.

Lens injury demographically affects patients of all ages, with 53% of patients falling between 7 and 30 years of age. Male patients are four times more often affected than female patients (Lamkin et al., Am J Ophthalmol 113:626–631, 1992).

Sometimes contused cataract and lens dislocation occurred simultaneously in one eye. Lens injuries often combined with anterior and posterior segment injuries, such as cornea contusion, hyphema, traumatic glaucoma, iridodialysis cleft, mydriasis, cyclodialysis cleft, vitreous hemorrhage, retinal detachment, choroidal detachment, etc.

The treatment for lens injury is either medical or surgical, based on patient’s symptoms, needs, and expectations. Few mild subluxation or intralenticular foreign body composed of nonferric or non-cupric material which does not affect the vision can be managed conservatively by careful observation. Most of lens injuries, like other forms of crystalline lens pathology, require surgical intervention. The mode of surgical varies individually. Surgical extraction is the most common method. Whether the intraocular lens can be implanted or not at the meantime mainly depends on the retinal conditions. Besides, other tissues injured together also need intervention. Combined surgery was a good choice to cure other complications. Most cases had a good vision after intervention, while few patients got poor prognosis due to fundus irreversible injury.