Trauma and lens 8
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  • 1. Trauma and lens
  • 2. Effects of blunt trauma
    • Vossius ring:
    • A ring of faint or stippled brown amorphous granules of iris pigments on the anterior capsule .
    • It has a diameter same as of contracted pupil (due to traumatic miosis that results as immediate effect of trauma)
    • Results due to the impression of the iris on the lens, produced by the force of the blow driving the iris backwards
    • Minute discrete subcapsular opacities may be seen after resorption of the pigment
  • 3.  
  • 4.
    • Concussion cataract
    • Mechanism: due to entrance of aqueous into the lens resulting from damage to capsule either due to loss of its semipermeability or due to actual tears in the capsule
  • 5.
    • May occur in various forms:
    • Discrete opacities involving the area of capsular tear
    • Rosette cataract:
    • Early rosette:
    • Usually starts in posterior cortex, sometimes the anterior cortex or both.
    • Accumulation of fluid marks out the architechtural arrangement of the lens so that the star shaped cortical sutures are delineated and feathery lines of opacities outlining the lens fibres radiate from them
    • Rosette cataract may occasionally disappear, may remain stationary or may progress to total opacification of the lens
  • 6.  
  • 7.
    • Late rosette:
    • Develops 2-3 yrs following the concussion
    • Smaller and more compact than the early rosette with shorter sutural extensions
    • Total cataract
  • 8.  
  • 9. Treatment
    • Delayed for a few months till the final outcome is visible and inflammation completely subsides, following which the treatment is similar to any other unilateral cataract
    • Immediate treatment may be indicated if lens becomes intumescent and secondary glaucoma results
  • 10. Other effects of blunt trauma
    • Traumatic absorption of lens: may occur in children
    • Subluxation/Dislocation of lens
  • 11. Effects of penetrating trauma
    • Rupture of the anterior capsule-> traumatic cataract
    • Vitreous in AC
    • Effects of trauma on other structures of the eye