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Snail shell on moon appearance: cataracta nigra over coloboma
Manu Sharma1, Deeksha Sharma1, Yvk Chaitanya1
1Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
QJM : Monthly Journal of the Association of Physicians
|August 20, 2025
Summary
A rare case of black cataract (cataracta nigra) dislocated posteriorly with iris coloboma and vitreous hemorrhage was treated successfully. Surgical intervention improved vision significantly in this unique presentation of ocular trauma.
Area of Science:
- Ophthalmology
- Medical Case Reports
Background:
- A 50-year-old Asian female presented with severe vision loss after blunt ocular trauma.
- Examination revealed a posteriorly dislocated cataracta nigra, iris coloboma, and vitreous hemorrhage.
Purpose of the Study:
- To report a rare case of cataracta nigra with fundal coloboma and vitreous hemorrhage.
- To describe the surgical management and visual outcome.
Main Methods:
- Pars plana vitrectomy to clear vitreous hemorrhage.
- Phacofragmentation of the cataracta nigra under perfluorocarbon liquid protection.
Main Results:
- A densely pigmented black cataract was found resting on the colobomatous area.
- Successful emulsification and removal of the cataract were achieved.
- Postoperative visual acuity improved to 6/60.
Conclusions:
- This case highlights a rare association of cataracta nigra, iris coloboma, and vitreous hemorrhage.
- Surgical management can restore significant visual function in such complex cases.
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