APHAKIA

Definition :

The absence of crystalline lens from the eye.

It may be considered a condition in which the lens is
absent from the pupillary area.
 CAUSES :

1. Congenital absence of lens. It is a rare condition

2. Surgical aphakia occuring after removal of lens is
the commenest presentation.

3. Aphakia due to absorption of lens matter is

noticed rarely after trauma in children.
4. Traunmatic extrusion of lens from the eye also
constitutes a rare cause of aphakia
5. Posterior dislocation of lens in the vitreous causes
optical aphakia.
APHAKIA
 REFRACTIVE ERROR

Produces a high degree of hypermetropia.

 CLINICAL FEATURES

Sypmtoms :

The only symptom in aphakia is marked defective

vision for near and far.
 SIGNS OF APHAKIA
1. Limbal scar may be seen in surgical aphakia.
2. Anterior chamber is deeper than normal.
3. Iridonesis i.e. tremulousness of iris can be
demonstrated.
4. Pupil is jet black in colour.
5. Purkinje’s image test shows only two images
( normally four images are seen)
6. Fundus examination shows hypermetropic small
disc.
7. Retinoscopy reveals high hypermetropia.
 TREATMENT
Modalities for correcting aphakia :

1. Spectacles
2. Contact lens
3. IOL
4. Refractive corneal surgery
 1. SPECTACLES
Most commonly employed method of correcting
aphakia.

 + 10 D with cylindrical lenses for surgically induced

astigmatism .
ADVANTAGES :

Cheap
Easy
Safe method.
 DISADVANTAGES :
1. Image magnification :
Image size is magnified by 30 % on an
average.
2. Spherical Aberrations :
Pin cushion distortion
3. Prismatic Aberrations :
Roving ring scotoma – usually describes as
jack in the box phenomena
JACK IN THE BOX
ROVING RING SCOTOMA
PIN CUSHION EFFECT
4. Restricted field of vision :
50 degree all around.

5. Colour vision : Coloured hue

6. Cosmetic blemish

7. Cumbersome to use

8. Problem of near vision

 2. CONTACT LENSES
• ADVANTAGES :
- Lens magnification of image
- Elimination of aberrations and prismatic effect
for thick glasses
- Wider and better field of vision
- Cosmetically more acceptable
- Better suited for uniocular aphakia
 DISADVANTAGES :

- More cost

- Cumbersome to wear , especially in old age

and in childhood

- Corneal complications may be associated

 3. INTRAOCULAR LENS IMPLANTATION

- Best available method of correcting aphakia.

- Commonest modality being employed.

4. REFRACTIVE CORNEAL SURGERY
- Keratophakia

- Epikeratophakia

- Hyperopic Laser assisted in-situ

keratomileusis ( LASIK )
THANKYOU..