Anterior dislocation of crystalline lens causing pupillary-block (phacotopic) glaucoma following blunt eye trauma

A healthy man in his 40s presented 12 hours after blunt eye trauma with painful vision loss in the right eye. Examination showed an intact crystalline lens dislocated into the anterior chamber and occluding the pupil, with intraocular pressure (IOP) 44 mm Hg. Initial medical stabilisation (oral acetazolamide, topical aqueous suppressants, topical steroids and oral prednisolone 40 mg one time per day) reduced IOP to 16 mm Hg over 72 hours while the cornea remained clear and the anterior chamber depth appeared relatively preserved superiorly.A detailed stepwise supplementary file describing our extraocular needle-guided haptic insertion manoeuvres has been provided as a supplementary file. Postoperatively the intraocular lens was well centred, IOP remained controlled and visual acuity improved progressively.