According to gradinmath.com, a lens luxation is a displacement of the lens in the eye. Trauma or a congenital defect causes it to move to the anterior chamber or vitreous body of the eye.
What is a lens luxation?
A lens luxation describes either a partial or complete displacement of the lens in the eye. In these cases, it shifts upward into the anterior chamber or backward into the vitreous. Displacement of just one lens is often associated with injury or trauma. If both eyes are affected, it is a malformation or a genetic predisposition.
If the dislocation is only partial, this is called subluxatio lentis or lens subluxation. If the lens shifts completely, it is called luxatio lentis or lens luxation in the specialist department. Both types fall under the term lens ectopia ( ectopia lentis ). With partial displacement in a light form, most often there are no complaints.
In many cases, when the lens is completely displaced, the zonula fibers are overstretched, causing so-called “lens trembling”. This is where the lens of the eye moves abnormally. In this case, the fibers that hold them in place, the zonula fibers, are either overstretched or already torn. As a result, the affected person develops severe short-sightedness.
Causes
There are several causes of lens luxation. External trauma such as a blow can be a reason for the lens not staying in place. Eye conditions such as glaucoma and cataracts can also shift the lens. 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 turns gray for various reasons. As the disease progresses, this results in the lens shrinking, putting the zonula fibers under tension. If they tear, the lens in the eye can shift. A tumor that occurs in the ciliary body can also affect the ciliary fibers, which in turn are unable to hold the lens in place. Again, the lens can shift.
In the case of a genetic disposition that often affects both eyes, the hanging apparatus of the eye lenses is impaired by connective tissue or metabolic diseases. In Marfan syndrome, Weill-Marchesani syndrome or homocystinuria, the zonular fibers are not developed appropriately for various reasons. The suspension of the lenses on both eye bodies is therefore not optimal.
Typical symptoms, complaints & signs
Slight displacements are often free of symptoms. The eye may water more than before, which is indicated by increased blinking. The eye may be red. The cornea, which is normally transparent, appears milky.
A more severe case results in double vision, which is medically called monocular double vision if it occurs in only one eye. Another consequence is extreme short-sightedness that occurs suddenly.
A punch in the eye can cause an eye bruise, a so-called contusio bulbi, in which the lens shifts. A so-called contusion rosette is the result, in which a star-shaped clouding of the rings can be seen. Bleeding makes the eyeball appear red.
Diagnosis & disease progression
When examining the eye with a slit lamp, the blind spot may appear twice. The lens is also reduced in size because the zonula 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 body. In this case, there is no improvement without surgery.
Complications
The lens luxation does not have to lead to symptoms or complications in every case. If the disease is only very mild, there are usually no symptoms. However, the eyes can water more, which leads to various restrictions in everyday life. Furthermore, those affected often suffer from reddened eyes.
Other visual problems can also occur as a result of the lens luxation. Thus, many patients suffer from double vision or blurred vision. Especially in children, development can be limited or delayed due to the lens luxation. It is not uncommon for the lens luxation to also lead to sudden visual problems, so that the patients suffer from sudden short-sightedness. Trembling movements are also common with this condition.
Dislocation of the lens can usually be treated with medication and eye drops. There are no further complaints. If there is a tumor, it must be removed to prevent further complications. In most cases, the course of the disease is positive and there are no further complications. The life expectancy of the affected person is not affected or reduced by the lens luxation.
When should you go to the doctor?
A lens luxation requires a medical evaluation. People who notice signs of a glaucoma should consult an ophthalmologist as soon as possible. Double vision and blurred vision are also symptoms that need to be clarified. If the signs of illness quickly become stronger, the best thing to do is to contact the medical emergency service. In case of doubt, the complaints must be taken to the clinic or doctor’s office. The lens luxation can be treated well with a visual aid.
However, if the condition is diagnosed too late, serious vision problems can develop. Then there is also the risk that the person concerned will go blind. For this reason, the first signs of an 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 luxation occurs. In the best case, this will prevent ectopia. The treatment is carried out by the ophthalmologist or the responsible specialist for the respective underlying disease.
Treatment & Therapy
After a traumatic event where the lens has shifted only slightly, the eye needs to heal and the ciliary muscles need to recover. Painkillers can help make the impairment bearable. Eye drops help in the healing process through disinfection. If there is a slight displacement for other reasons, glasses or contact lenses can already help to correct the vision.
If the lens is noticeably shifted or has even disappeared completely from its usual 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 job as the natural lens. Especially in the case of glaucoma and cataracts as well as a tumor, an operation is often the only way to restore or improve vision.
During the operation, the sclera is cut to gain access to the lens. The lens is then removed. The eye is rinsed and then treated with medication so that healing can take place without any problems. A new lens is inserted and the wound sewn up.
In many cases, this operation can be performed on an outpatient basis and under local anesthesia, so that the patient can go home the same day. There he should rest and not strain his eyes for the first few days. The eye must be treated regularly with eye drops. A final examination is carried out after one to two weeks.
Outlook & Forecast
Lens luxation has a favorable prognosis. For many of those affected, no further treatment measures are necessary. The irregularities are so minor that there are no serious impairments in coping with everyday life. In many cases, vision corrections are made or drug treatment is initiated.
If the symptoms are severe, the irregularity can be corrected by surgery. If this proceeds without further complications, the patient is then released from the treatment as recovered. Check-ups should be carried out at regular intervals so that the eyesight can be documented and any changes can be reacted to as quickly as possible.
In some patients, the cause of lens luxation is tumor formation. For them, the prognosis is determined based on the stadium of the tumor. In the case of a malignant tumor development and an advanced stage of the disease, metastases can form in the organism. In severe cases, the victim may die. The sooner the tumor can be diagnosed and treated, the better the long-term chances of recovery. Nevertheless, there is a risk of suffering consequential damage or having long-term impairments of vision certified. This development worsens the prognosis overall. The quality of life is declining and a restructuring of everyday processes is necessary. This can lead to mental and emotional stress.
Prevention
In order to prevent lens luxation, it helps to have regular check-ups with an ophthalmologist. There, diseases such as cataracts and glaucoma are recognized in good time. This walk is also recommended for those with disabilities.
Aftercare
The aftercare of a lens luxation depends in its exact form on the type and severity of the disease. As a rule, it is the ophthalmologist who gives the patient concrete recommendations for action and also specifies the duration of their application. The success of the measures or the previous therapy may be checked again in several follow-up checks.
It is particularly important to avoid irritation of the eyes at all costs, and thus not only aftercare, but often also precautionary measures with regard to a possible recurrence. For the patient, this means, for example, protecting the eyes from bright sunlight with suitable glasses, not wearing contact lenses and taking measures to moisturize the eyes if these are recommended by the doctor.
Follow-up care can sometimes involve changes in skin care. Harsh cleansers for the face, especially those containing alcohol, are not suitable. Make-up should not be used if possible. When shampooing your hair, make sure that surfactants do not get in your eyes. Solarium users should only go into the cabin with adequate protection, as the blower can dry out the eyes and the excessive light can also irritate the eyes.
You can do that yourself
In the case of a lens dislocation, the most important measure is to rest the affected eye. The patient should expose the eye to as little sunlight and irritating substances as possible. Shampoo and other care products should also only be used in consultation with the doctor in order to avoid serious complications.
If there are any problems in the eye area, the doctor must be informed. If the course is positive, it is sufficient to keep your eyes closed for a few days – this can be done with special eye patches – and possibly wear glasses. If the lens is severely displaced, an operation must be performed. After the procedure, the person concerned 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 initially be protected. Driving and working on a computer should be avoided for at least a week. In addition, the eye must be treated with eye drops. With the consent of the doctor, alternative means from naturopathy are allowed. After two weeks, the doctor must be visited again for the final examination.