Sistem Kedaruratan &

Traumatologi
Lens Dislocation
Dr.A.AFIFUDIN Sp M
Bagian I.K. Mata Fakultas Kedokteran
UNIVERSITAS HASANUDDIN

 Trauma

Oculi = Ocular Injury

a) Blunt Ocular Injury

b) Penetrating Ocular Injury
c) Chemical Ocular Injury

Blunt Ocular Injury

Compressive force results in vascular disruption and bleeding into the

globe. (From Shingleton BJ, Hersh PS, Kenyon KR : Eye Trauma. St. Louis,
C.V. Mosby, 1991, p.105, with permission.)

The seven typical anterior tears that occur following blunt trauma to the
eye. (From Shingleton BJ, Hersh PS, Kenyon KR: Eye Trauma. St. Louis, C.V.
Mosby, 1991, p.118, with permission.)

Angle recession, a tear in the anterior face of the ciliary body

between the longitudinal and circular ciliary body muscle (tear
within the ciliary body itself)
Cyclodialysis is a tear between the ciliary body and the scleral
spur (ciliary body is torn from its attachment at the scleral
spur)
Disinsertion of the uvea from the sclera allows free passage of
the anterior chamber aqueous fluid to the suprachoroidal
space, therefore permitting direct access to the uveoscleral
outflow pathway. Temporary or permanent hypotony is usual.
A cyclodialysis cleft should be suspected and carefully
searched for when the IOP remain low after ocular trauma
Trabecular meashwork trabecular meashwork tear
Iridodialysis separation of the iris from iris root/peripheral
iris
Retinal dialysis separation of the retina from the ora serrata

The ocular injuries that may be associated with a traumatic

hyphema

A hyphema is blood in the anterior chamber.

The appearance of a hyphema may range from microscopic,

seen only at the slit lamp as erythrocyt circulating in the
aqueous, to total hyphema that fills the entire anterior
chamber

Pathophysiology of a traumatic hyphema : blunt ocular trauma

result in ocular indentation, which causes a sudden expansion
of ocular tissues and an immediate rise in the IOP. The sudden
forceful displacement of the cornea and limbus posteriorly and
peripherally may result in splitting or tearing of these tissues.
As the tissues tear, blood vessels in the vicinity may rupture,
resulting in a hyphema

ECTOPIA LENTIS

Ectopia lentis is lens displacement, may occur as congenital,

developmental or acquired disorder
Subluxated lens, is partial displacement of the lens from its
normal position but still within pupillary area
Luxated / dislocated lens, is complete displacement of the
lens out pupillary area
Symptoms and signs of subluxation :
- decreased vision
- astigmatism
- monocular diplopia
- iridodenesis

Ectopia lentis complications:

- cataract
- dislocation to anterior chamber
- dislocation at the pupil pupillary block
and angle closure glaucoma
- dislocation to posterior vitreous cavity

Management:
Lens extraction (surgery)