Lens dislocation

As Lens dislocation a displacement of the lens in the eye is called. Due to trauma or a congenital defect, it moves into the anterior chamber or into the vitreous humor of the eye.

What is lens dislocation?

Slight shifts are often symptom-free. It may be that the eye is watering more than before, which is evident from the increased blinking.
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A Lens dislocation describes either a partial or complete displacement of the lens in the eye. In these cases it shifts upwards into the anterior chamber or backwards into the vitreous humor. Moving just one lens is often an injury or trauma. If both eyes are affected, it is either a deformity or a genetic predisposition.

If the dislocation occurs only partially, this will happen Subluxatio lentis or called lens subluxation. If the lens moves completely, according to the department Luxation lentis or lens dislocation. Both types fall under the concept of Lens ectopy (Ektopia lentis). With the partial shift in a slight form, there are usually no complaints.

In many cases, when the lens is completely displaced, the overstretching of the zonular fibers causes a so-called "lens slap". The lens of the eye can move abnormally in the eye. The fibers that hold them in place, the zonular fibers, are either overstretched or already torn in this case. As a result, the affected person develops severe myopia.

causes

There are several causes of lens dislocation. External traumatic impact, such as a blow, can be a reason that the lens does not stay in place. Eye disorders such as glaucoma and cataracts can also move the lens. For example, in glaucoma, which is medically known as glaucoma, the pressure in the eye is so high that the lens is pushed forward.

In cataracts, also called cataracts in medicine, the lens becomes cloudy for various reasons. In the advanced stages of the disease, this results in the lens shrinking and thus putting the zonular fibers under tension. If they tear, the lens can shift in the eye. A tumor that appears in the ciliary body can also affect the ciliary fibers, which in turn cannot hold the lens in place. Here, too, the lens can shift.

In the case of a genetic disposition that often affects both eyes, the suspension system of the eye lenses is impaired by connective tissue or metabolic diseases. In Marfan's syndrome, Weill-Marchesani syndrome or homocystinuria, the zonular fibers are not developed accordingly for various reasons. The suspension of the lenses on both bodies of the eye is therefore not optimal.

Typical symptoms, complaints & signs

Slight shifts are often symptom-free. It is possible that the eye is watering more than before, which is evident from the increased blinking. The eye may be red. The cornea, which is usually transparent, appears milky.

In a more severe case, double images are the result, which is called monocular double vision in medicine, provided that only occurs in one eye. Another consequence is sudden, extreme myopia.

A bruise, called a bruise, can occur after a fist on the eye Contusio bulbi come with the lens shifting. A so-called contusion rosette is the result in which a star-shaped opacity of the rings can be seen. Bleeding makes the eyeball appear red.

Diagnosis & course of disease

If the eye is examined with a slit lamp, the blind spot may appear twice. The lens is also reduced in size because the zonular fibers are no longer able to pull them taut. So it appears rounded and performs trembling movements. If the lens has slipped completely, it can be found on the bottom of the vitreous. In this case, there will be no improvement without surgery.

Complications

The lens dislocation does not always lead to discomfort or complications. If the disease is only very mild, there are usually no symptoms. However, the eyes can water more strongly, so that there are various restrictions in everyday life. Furthermore, those affected often suffer from reddened eyes.

The lens dislocation can also cause other visual problems. Thus, many patients suffer from double vision or blurred vision. Especially in children, the development can be limited or delayed due to lens dislocation. It is not uncommon for lens dislocation to lead to sudden visual problems, so that patients suffer from sudden myopia. Trembling movements are also common with this disease.

Usually, lens dislocation can be treated with medication and eye drops. There were no further complaints. In the event of a tumor, it must be removed so that there are no further complications. In most cases, the disease progresses positively and no further complications arise. The life expectancy of the person affected is also not influenced or reduced by the lens dislocation.

When should you go to the doctor?

A lens dislocation requires medical clarification. People who notice signs of a glaucoma are best advised to consult an ophthalmologist promptly. Double vision and blurred vision are also symptoms that need to be clarified. If the symptoms get worse quickly, it is best to contact the emergency medical service. If in doubt, you must go to the clinic or doctor's office with the complaints. The lens dislocation can be treated well with a visual aid.

However, if the condition is diagnosed too late, serious visual disturbances can develop. Then there is also the risk that the person concerned will go blind. For this reason, the first signs of ectopia should be clarified by a doctor. The condition often occurs in connection with Marfan syndrome or Ehlers-Dahlos syndrome. Hereditary bone malformations are also possible triggers, which are best clarified before the lens dislocation occurs. In the best case scenario, this prevents ectopia. The treatment is carried out by the ophthalmologist or the responsible specialist for the respective underlying condition.

Therapy & Treatment

In the event of a traumatic impact in which the lens is only slightly displaced, the eye must heal and the ciliary muscles recover. Painkillers can help make the impairment bearable. Eye drops help in the healing process through disinfection. If there is a slight shift for other reasons, glasses or contact lenses can already help with vision correction.

If the lens is noticeably displaced or has even completely disappeared from its familiar environment, it must be removed with the help of an operation and replaced with a new, artificial one. These are made of plastic. They enable normal vision because they perform the same task as the natural lens.Especially with glaucoma and cataracts as well as with a tumor, an operation is often the only way to restore or improve eyesight.

The operation involves cutting the dermis to gain access to the lens. The lens is then removed. The eye is rinsed and then medicated so that healing can take place without any problems. A new lens is inserted and the wound sutured.

In many cases, this operation can be performed on an outpatient basis and under local anesthesia so that the patient can go home on the same day. There he should rest and not strain his eyes for the first few days. The eye must be supplied with eye drops regularly. A final examination will be carried out after one to two weeks.

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Outlook & forecast

The lens dislocation has a favorable prognosis. For many of those affected, no further treatment measures are necessary. The irregularities are so small that there are no serious impairments in coping with everyday life. In many cases vision corrections are made or drug treatment initiated.

In the event of severe discomfort, the irregularity can be corrected by surgery. If this goes without further complications, the patient is then discharged from treatment as recovered. Check-ups should take place at regular intervals so that the eyesight can be documented and changes can be made as quickly as possible.

In some patients, the cause of the lens dislocation is a tumor formation. With them, the prognosis is determined based on the stage of the tumor. With a malignant tumor development and an advanced stage of the disease, metastases can develop in the organism. In severe cases, there is a risk of death. The sooner the tumor can be diagnosed and treated, the better the long-term chances of recovery. Nevertheless, there is a risk of suffering secondary damage or of having long-term impairment of vision certified. This development worsens the prognosis overall. The quality of life decreases and a restructuring of the daily processes is necessary. This can lead to psychological and emotional stress.

prevention

To prevent lens dislocation, it helps to have a regular check-up with an ophthalmologist. Diseases such as gray and glaucoma are recognized there in good time. This course is also recommended for impairments.

Aftercare

The exact extent of follow-up care for a lens dislocation depends on the type and severity of the disease. As a rule, it is the ophthalmologist who gives the patient specific recommendations for action and also specifies the duration of their use. The success of the measures or the previous therapy may be checked again in several follow-up controls.

It is particularly important to avoid irritation of the eyes at all costs and thus not only aftercare, but often also precaution with regard to a possible relapse. For the patient, this means, for example, protecting the eyes from glaring sunlight with suitable glasses, refraining from wearing contact lenses and taking measures to moisten the eyes if recommended by the doctor.

Follow-up care can also bring about changes in skin care routine. Harsh cleansers for the face, especially those containing alcohol, are not suitable. Make-up shouldn't be used if possible. When shampooing your hair, make sure that surfactants do not trickle into your eyes. Solarium users should only go into the cabin with sufficient protection, as the blower can dry out the eyes and the excessive light also irritates the eyes.

You can do that yourself

In the case of a lens dislocation, the most important measure is to protect the affected eye. The patient should expose the eye as little as possible to sunlight and irritating substances. Shampoo and other care products should only be used in consultation with the doctor in order to avoid serious complications.

Should there be any discomfort in the eye area, the doctor should be informed. If the outcome is positive, it is sufficient to keep the eye closed for a few days - this can be achieved with special eye patches - and possibly wear glasses. If the lens is badly displaced, a surgical procedure must be performed. After the procedure, the person affected should keep a diary of any abnormalities so that the doctor can optimally adjust the accompanying drug therapy.

Even after an operation, the affected eye must first be spared. Driving and working on the computer should be avoided for at least a week. In addition, the eye must be treated with eye drops. Alternative naturopathic remedies are permitted with the consent of the doctor. After two weeks the doctor must be visited again for a final examination.