ABSTRACT

TRAUMATIC ANTERIOR LENS DISLOCATION WITH IRIDODIALYSIS

Vandaristya Pantristi Ardani, Indri Wahyuni
Department of Ophthalmology, Faculty of Medicine Airlangga University, Dr. Soetomo General
Hospital Surabaya

Introduction and Objective: To present management of traumatic anterior lens dislocation with
iridodialysis.

Case presentation: A case report of 53 years old woman with sudden blurred vision on right eye, two
weeks after hit by a belt. History of pain, tearing, redness and seeing halo was positive. Her visual acuity
on the right eye was hand movement with projection of illumination good in all direction and good in
red green test. IOP in the right eye was 37.2 mmHg. Anterior segment examination of the right eye
showed conjunctival hyperemia, corneal edema, coagulum and vitreous in anterior chamber,
iridodialysis at 4 until 8 o’clock, pupil not round and dilated around 9 mm in diameter, opaque lens and
fully dislocated into anterior chamber. Under direct funduscopic examination of her right eye, red reflect
was found, but other detail was unable to evaluated. Ultrasonography on right eye revealed vitreous
hemorrhage and posterior vitreous detachment. Patient underwent one step cataract extraction surgery
and iridodialysis repair to lowering the IOP. IOP in the first day, first week, first month and second
month after surgery was 32 mmHg, 27 mmHg, 23 mmHg, and 20 mmHg.

Conclusion: Lens dislocation and iridodialysis are a critical case that need a prompt diagnosis and early
management to prevent vision-threatening glaucoma and ensure good result after surgery. Follow up
after surgery is still required to monitoring IOP and other structural damage of the anterior and posterior
section of the eye that can lead to further irreversible visual impairment.

Keywords: traumatic anterior lens dislocation, iridodialysis