This document discusses aphakia and pseudophakia. It defines aphakia as the absence of the eye's natural lens, which can be congenital or due to trauma or surgery. It describes how aphakia affects the eye's optics and visual acuity. Treatment options for aphakia include spectacles, contact lenses, intraocular lens implantation, and refractive corneal surgery. Pseudophakia refers to the condition after an intraocular lens is implanted to correct aphakia. The document outlines the signs and management of pseudophakia.

1. A L K A M I S H R A .
2 N D Y E A R B S C O P T O M E T R Y .
A B H A Y A C O L L E G E O F
O P T O M E T R Y .
APHAKIA AND PSEUDOPHAKIA
Presented By

4. causes
 Congenital absence of lens (rare condition ).
 Traumatic extrusion of lens from eye.
 Surgical aphakia .

6. Optics of aphakia eye
 Changes In cardinal data of the eye.
 Image formation in the aphakia eye.
 Visual acuity in aphakia.
 Accommodation in aphakia.

7. Clinical Features
Symptoms : Defective vision for near and far.
Signs of aphakia include the following:
 Limbal scar may be seen in surgical aphakia.
 Anterior chamber is deeper than normal.
 Pupil is jet black in colour.
 Purkinjes image test show only two images.
 Fundus examination show hypermetropic small disc.
 Retinoscopy reveals high hypermetropia.

8. Treatment
 Optical principle is correct the error by convex lenses of
appropriate power , so that the image is formed on the
retina.
Modalities for correcting aphakia include :
Spectacles
Contact lens
IOL
Refractive corneal surgery

9. Spectacles
 Most common.
 +10D is used.
 Cylindrical lens required in surgically induced
aphakia.
 An addition of +3D to +4D is required for near vision
to compensate the loss of accommodation.

10. Advantages of spectacles
 It is a cheap.
 Easy and safe method of correcting aphakia.
Disadvantage of spectacles
 Image is magnified by 30%.
 Problem of spherical and chromatic aberration of
thick lenses.
 Prismatic effect of thick and heavy glasses.

11. Contact Lenses
Advantages of contact lenses
 Less magnification of image.
 No chromatic aberration.
 No prismatic affect.
 Wider and better field of vision.
Disadvantages
 More cost.
 Cumbersome to wear , especially in old age and in childhood.
 Corneal complication may be associated.

12. Intraocular lens implantation

13. Refractive corneal surgery
It Is under trial for correction of aphakia . It includes
the following :
 Keratophakia.
 Epikeratophakia.
 Hyperopic LASIK.

17. PSEUDOPHAKIA
The condition of aphakia when corrected with
implantation of an IOL is referred to as
pseudophakia or artiphakia.

20. Emmetropia
It is produced when the power of the IOL implanted
is exact .It is the most ideal situation . Such
patients need plus glasses for near vision.

26. Sign of Pseudophakia with posterior chamber
IOL
 Surgical scar may be seen near the limbus.
 Anterior chamber is slightly deeper than normal.
 Purkinje image test shows four images.
 Pupil is blackish in colour.

27. Management
 Spectacles for near vision alone ( in pseudophakia
with emmetropia ) or as bifocal/progressive
glasses for both distance and near vision ( in
pseudophakia with consecutive refractive error )
are required.
 LASIK orAdvanced surface ablation (ASA) may be
required in moderate consecutive refractive error.
 Intraocular lens exchange or pigiback IOL is required
when the consecutive refractive error is large.