 The lens is absent from the pupillary area

 Congenital absence
 Dislocation into the vitreous
 Extruded outside the eye
 Surgically removed
 Absorption of the lens matter
 Changes in the cardinal data of the eye

 Image formation in the aphakic eye

 Visual acuity in aphakia

 Accommodation in aphakia

 Binocular vision in aphakia

 Eye is highly
hypermetropic
 Power is reduced to
44D (60D)
 Anterior focal point is
23.2 mm in front of
cornea
(17.2mm)Posterior
focal point is 31mm
behind cornea
(24.4mm)
 Principal points are at
the anterior surface of
cornea ( 1.5mm
behind)
 Nodal points are 7.75
mm behind anterior
surface of cornea
(7.2mm)
 Image size in aphakia corrected with
spectacles is 30% magnified

 Image size in aphakia corrected with contact

lens is magnified by 4.5 to 5%
 Visual acuity of spectacle corrected eye is
recorded better than actual visual acuity in
terms of visual angles
 Total loss of accommodation

 Bifocal or progressive spectacles

 Multifocal IOLs
 Monocular aphakia corrected with spectacles
will result in aniseikonia

 Can be corrected with IOL or Contact lens

 Operative scar at limbus
 Deep AC
 Iridodonesis
 Jet black pupil
 Absent Purkinje images
(3,4)
 Associated
abnormalities
 High hyperopia
 Fundus exam -small disc
 Spectacle

 Contact lens

 Intra-ocular lens

 Refractive corneal surgery

 Total dioptric power = +58 D Cornea= +42 D Lens= +16 D
Refractive state = Emmetropia

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Total dioptric power = +42 D Cornea= +42 D Lens= +0 D
Refractive state = High Hypermetropia

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 A high power (thick) convex lens is required to correct vision

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• +10 D lens with correction of associated
astigmatism ( usually ATR )
• Add + 3 D for near vision ( Total +13D )

Advantages
• Cheap
• Easy
• safe
 Many disadvantages

 Heavy glasses

 Poor cosmetic appearance

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 Many disadvantages

 Magnification of 30% - unilateral aphakia, assess

distance
 • Spectacle magnification=
Corrected image size
Uncorrected image size

Anterior focal distance in ametropia

Anterior focal distance in emmetropia

23.2 = 1.36 = 30 % magnification

17.05

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False depth perception

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False depth perception

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False depth perception

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False depth perception

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False depth perception

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False depth perception

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False depth perception

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 Many disadvantages

 Restricted field of vision

 Roving ring scotoma

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7/21/2019 Ring scotoma-
 ?

7/21/2019 Ring scotoma-

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7/21/2019 Ring scotoma-
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7/21/2019 Roving Ring scotoma-
7/21/2019 Jack in the box-
 Spherical aberrations – pincushion defect
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 Spherical aberrations – pincushion defect

 Coloured vision

 Separate glasses for near

 Total dioptric power = +58 D Cornea= +42 D Lens= +16 D
Refractive state = Emmetropia

7/21/2019
 Total dioptric power = +42 D Cornea= +42 D Lens= +0 D
Refractive state = High Hypermetropia

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 CONTACT LENS

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• +13 D contact lens
• For near vision – spectacle correction is needed ( Add +3D )
• Advantages-
– Less magnification
– Less prismatic distortions
– Better field of vision
– Better cosmetically
– Better for uniocular aphakia
• Disadvantages-
– Requires good maintenance
– Cost
– cumbersome
• Lens is placed inside the eye
• Positions and power
– ACIOL- +17D
– Iris fixated- +18D
– PCIOL- +20 D
• Advantages
– Good optics
– Permanent
• Disadvantages-
– Surgical procedure - complications
 Parts
Optic
Haptic

 Material
PMMA
Silicone
Hydrogel
 Keratophakia

 Epikeratophakia

 Hyperopic Lasik - Can correct small amounts

of hyperopia up to 4 D