TNOA Journal of Ophthalmic Science and Research

PHOTO ESSAY
Year
: 2021  |  Volume : 59  |  Issue : 2  |  Page : 210--211

All that glitters is not cornea: A case of crystalline lens extrusion


Harinikrishna Balakrishnan1, M Rajkumar2,  
1 Department of Ophthalmology, Aravind Eye Hospital, Madurai, Tamil Nadu, India
2 Aravind Eye Care System, Madurai, Tamil Nadu, India

Correspondence Address:
Dr. Harinikrishna Balakrishnan
Aravind Eye Hospital, No. 1, Anna Nagar, Madurai - 625 020,Tamil Nadu
India




How to cite this article:
Balakrishnan H, Rajkumar M. All that glitters is not cornea: A case of crystalline lens extrusion.TNOA J Ophthalmic Sci Res 2021;59:210-211


How to cite this URL:
Balakrishnan H, Rajkumar M. All that glitters is not cornea: A case of crystalline lens extrusion. TNOA J Ophthalmic Sci Res [serial online] 2021 [cited 2021 Sep 21 ];59:210-211
Available from: https://www.tnoajosr.com/text.asp?2021/59/2/210/319263


Full Text



A 41-year-old female presented with complaints of defective vision and pain in the right eye for 4 weeks. The patient was healthy with no history of systemic ailments, autoimmune diseases, ocular surgeries, and denied any trauma. The patient gave a history of using topical medications in the right eye prescribed in a rural primary health-care center for the past 3 weeks. Owing to the travel restrictions of lockdown due to the COVID 19 pandemic, the patient could not commute to a tertiary eye care center in the early stage. The patient presented to us 4 weeks after the onset of symptoms. The best-corrected visual acuity was perception of light in the right eye and 20/20 in the left eye. Anterior segment examination revealed complete extrusion of the crystalline lens and prolapsed iris due to corneal melting most probably due to microbial keratitis [Figure 1]a and [Figure 1]b. The anterior segment evaluation of the left eye was found to be normal with no evidence of corneal thinning. The patient was admitted immediately, and the lens was extracted under local anesthesia. Due to the late presentation of the patient, culture and sensitivity test of the lens and the conjunctiva werer found to be inconclusive, and the causative organism could not be isolated. Systemic workup for autoimmune disease proved to be negative. At follow-up after 2 weeks, the wound was found to be healing with the formation of pseudocornea and the eye had gone into phthisis [Figure 2]. Lens expulsion is a complication of corneal melting.[1] It can occur in thinned corneas, infective keratitis, or following penetrative keratoplasty.[1],[2] Early presentation would have aided in treating the corneal infection appropriately and saving the vision. This case exemplifies the importance of using appropriate medications and early referral to tertiary eye care centers which would have been pivotal in salvaging the eye.{Figure 1}{Figure 2}

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Saleh G, Kazakos D, Patel J, Gormley P. An unusual case of corneal perforation with crystalline lens extrusion secondary to pseudomonas keratitis in the presence of rheumatoid arthritis. Eye 2004:18:437-9.
2AlQahtani B, Abdelaal A, Karamallah E. Spontaneous cataractous lens extrusion in a Patient with corneal melting. Case Rep Ophthalmol 2020;11:177-80.