Rupture of anterior lens capsule from blunt ocular injury

We report 3 cases of blunt trauma causing rupture of the anterior lens capsule with cataract formation. The injuries were caused by a paintball gun, a ball-bearing air pistol, and an aluminum rivet. In all 3 cases, the anterior capsule tears were central and the posterior capsules and zonules intact; uneventful cataract extraction with implantation of an intraocular lens was performed. The postoperative visual acuities was 20/40 in 1 case and 20/20 in the other 2 cases. We propose that the anterior lens capsule may have been torn by direct contusion from rapid focal indentation of the cornea onto the lens (coup injury) or by a fluid-mechanical, anteriorly directed rebound of the vitreous, bursting open the anterior capsule (contrecoup injury).