Anterior chamber abnormalities and cataract

Material occurring in the anterior chamber as a result of trauma may be of little or major significance. The most common finding requiring treatment is hyphema. Close observation and (often surgical) treatment is especially important in patients at high risk: those with sickle cell disease, rebleeding, and elevated intraocular pressure. Cataract is a common complication in eyes sustaining serious trauma, although its presence may be difficult to confirm during the initial repair. The diagnosis is especially crucial because of the significantly increased risk of endophthalmitis. If the surgeon is able to determine that cataract is indeed present and hinders visualization of the posterior segment, or may lead to rapid elevation of the intraocular pressure, primary lens removal should be considered because vitreoretinal injuries are expected in approximately one-half of eyes, and an early retinal examination is mandatory in all eyes with lens trauma. Because one out of two eyes have posterior capsule injury, vitrectomy methods of lens removal are commonly required. Preservation of the posterior capsule is less important than avoiding traction on the anterior vitreous, because alternative methods of intraocular lens placement offer similar functional results.