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Incidentally detected detached iris pigmentary epithelium
*For correspondence: aakankshabele@gmail.com
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This article was originally published by Wolters Kluwer - Medknow and was migrated to Scientific Scholar after the change of Publisher.
A 65 yr old male† patient presented to the Ophthalmology outpatient department of Acharya Vinoba Bhave Hospital of Datta Meghe Institute of Medical Sciences, Wardha, India, in October 2019, with complaints of diminution of vision in the left eye which was pseudophakic. Left eye appeared to be normal and refraction was given. While examining the right eye of the patient, it was seen that vision was restricted to accurate projection of rays. There was exotropia of 60 dioptres (Fig. 1). Further examination of the right eye revealed pigmented plaque on the front surface of the lens (Fig. 2); pupillary reaction to light was normal in both the eyes. After dilating the right eye, there appeared total cataract with iris pigmentary epithelium, which was attached to the anterior capsule (Fig. 3). On detailed questioning, the patient gave a history of trauma to the right eye with thorn when he was 12 yrs old, for which he never got treated. B-scan ultrasound of the right eye revealed a membranous cataract, with posterior segment apparently normal (Fig. 4).
- Image showing patient having exotropia of 60 dioptres.
- Image of undilated pupil showing pigmented plague on the lens surface, of right eye (red arrows).
- Dilated pupil showing evidence of total cataract with iris pigment stuck to anterior lens capsule.
- B-scan image suggestive of membranous hyper-reflectivity in the anatomical location of lens with reverberation echoes. Sonologically, posterior segment appears to be normal.
There could be two plausible pathways leading to this condition. First, there might have been a penetrating injury to right eye which apparently led to inflammation followed by anterior uveitis, leading to membranous cataract. However, there was no sign of penetrating injury on anterior-segment examination. Second, traumatic cataract caused due to blunt trauma to the right eye which progressed to phacolytic uveitis which might have caused the posterior synechiae which later broke leaving behind the current picture.
Conflicts of Interest: None.
