Ultrasound Evaluation of Lens Dislocation with Iridodonesis

Point-of-care ultrasound can be used in the emergency department to quickly diagnose intraocular lens dislocation, a rare but vision-threatening condition. Traumatic dislocated intraocular lenses may also be associated with iridodonesis, which is rapid vibration of the iris with eye movements due to lack of normal iris support from the lens.

We present the case of a 69-year-old female with traumatic acute lens dislocation sustained after mechanical ground-level fall at her nursing facility. Additionally, she was found to have iridodonesis, which was recorded with ultrasound video. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Emergency physicians should know that point-of-care ultrasound is a fast, reliable, and inexpensive way to diagnose lens dislocation, which may cause irreversible vision loss if missed. Further, when appreciated on ultrasound, iridodonesis should significantly raise concern for a diagnosis of lens dislocation.