Aphakia is the absence of the crystalline lens in the eye. It can be congenital or acquired through cataract surgery. Patients with aphakia experience high hyperopia and a loss of accommodation. Treatment options include spectacle correction, contact lenses, intraocular lens implantation, or refractive corneal surgery. Each option has advantages and disadvantages related to image quality, comfort, risk of complications, and cost.

2. APHAKIA
It is absence of crystalline lens in its normal
position in the eyeball. It may be congenital
absence of crystalline lens or acquired (surgical
removal of lens as after cataract surgery). It
creates a high degree of hypermetropia

4. Causes
1. Congenital absence of crystalline lens.
2. Surgical aphakia, e.g. after cataract surgery
3. Traumatic aphakia: Lens is expelled out due
to some injury.
4. Spontaneous absorption of lens may occur
sometimes producing aphakia.
5. Posterior dislocation of lens in the vitreous
cavity.

5. Clinical Features
Patient complains of marked loss of vision for distance
and near, as there is total loss of accommodation.
1. Surgical scar mark may be seen on the limbus.
2. Anterior chamber is deep.
3. Iris shows tremulousness (Iridodonesis) on the
movement of the eyeball.
4. Pupil is jet black in color.
5. 3rd and 4th Purkinje images are absent.
6. Fundus shows a small disk with indistinct disk
margins.
7. Retinoscopy shows high hypermetropia.

7. Treatment
• SPECTACLE
• CONTACT LENS
• IOL
• REFRACTIVE CORNEAL SURGEY

8. ADVANTAGES OF SPECTACLE
CORRECTION
• Easy
• Safe
• Inexpensive

10. DISADVANTAGES OF SPECTACLE
CORRECTION
1. Increased retinal image size
2. Decreased field of view
3. Presence of ring scotoma
4. Increased lens aberrations
5. Motion of object in field of view
6. Appearance of the wearer
7. Increased ocular rotations
8. Demand on convergence

11. ADVANTAGE OF CONTACT LENS
1. Image magnification is 7-8 % and this
magnification is usually tolerated by the
patients
2. Increase in the visual field. ( both central and
peripheral)
3. In monocular cases diplopia is usually absent
with retention binocularity.
4. Cosmetically it is well accepted.

13. DISADVANTAGES OF CONTACT LENS
1. Foreign body sensation
2. Corneal complications
3. Lens spoilage
4. Spectacles may be required over contact
lenses for reading
5. High +Rx lenses more likely to decentered

14. ADVANTAGES OF IOL IMPLANTAION
1. Little image magnification
2. No spherical and prismatic aberration
3. Minimum or no aniseikonia
4. Normal peripheral field
5. Cosmetically well accepted

16. DISADVANTAGES OF IOL
IMPLANTATION
1. Risks and complications may be more o
Infections o Expulsive choroidal hemorrhage
o Cystoid macular edema o Retinal
detachment o Corneal edema o Dislocation
of IOL ( child rubbing eye) o Posterior
capsular opacities
2. It needs specially qualified surgeons and
sophisticated instrument.
3. The cost is more

17. complications
• Aphakic glaucoma
• Retinal detachment