Bilateral posterior crystalline lens dislocation- A case report

A 73-year-old man was sent to the emergency department due to several seizures. He had a history of epilepsy and a cerebral vascular accident resulting in cognitive and verbal impairment. After neurologic evaluation and a Computed Tomographic (CT) scan of the brain, an ophthalmology consultation was requested because he had difficulty recognizing family members for the past 6 months. An anterior segment examination revealed absence of bilateral crystalline lens. Due to the patient’s inability to cooperate with a funduscopic examination, previous CT scans of the brain were reviewed. The scan from 3 years ago showed bilateral lens in normal anatomical position, and 1 year ago, bilateral lens subluxation, more prominent in the right eye. Upon this visit, CT scan showed bilateral lens posteriorly dislocated into vitreous cavity.

Lens dislocation is most commonly caused by trauma, particularly in individuals with zonular weakness, while bilateral occurrence is very rare. The patient exhibited no marfanoid physical features and had normal blood homocysteine levels. His family members refused surgical intervention, so outpatient follow-up was recommended.

Dr Chou graduated from National Yang Ming Chiao Tung University. She received residency and fellowship training at Taipei Veterans General Hospital. She currently works at Taipei City Hospital Zhongxing Branch, specializing in cataract, corneal and oculoplastic surgery.