Spontaneous anterior lens dislocation: case report and surgical management

Spontaneous anterior lens dislocation causes significant vision loss without prompt management. It is commonly associated with trauma or congenital connective tissue disorders. Moreover, ocular conditions like microspherophakia and hypermature cataracts can also predispose patients to lens dislocation. We present a case of spontaneous anterior lens dislocation and its surgical management.

We report the case of an 84-year-old female with a history of hypertension and diabetes mellitus who presented with sudden visual decline in her left eye. She had no prior trauma or hereditary ocular disease. Examination revealed a corrected visual acuity of 20/40 in the right eye and hand motion in the left with normal Intraocular pressures (IOP) in both eyes. Slit-lamp examination demonstrated inferonasal dislocation of a microspherophakic lens into the anterior chamber. Imaging confirmed lens dislocation without additional posterior segment pathology. The patient underwent successful manual small-incision cataract surgery with removal of the dislocated lens. Postoperative management included antiglaucoma medications to control elevated IOP, which stabilized her condition.

Spontaneous anterior lens dislocation is commonly associated with trauma or systemic connective tissue disorders, and reports without these factors are rare. Here, microspherophakia likely contributed to zonular weakness and predisposed the lens to dislocation, consistent with reports linking this condition to lens instability. Early diagnosis and management are essential to prevent complications like glaucoma and corneal decompensation.

Spontaneous anterior lens dislocation requires early diagnosis and individualized surgical management to ensure safe outcomes and reduce the risk of vision-threatening complications.