CASE OF BINOCULAR SUBLUXATION OF THE LENS IN A CHILD

By HANS RAJ, m.b., b.s., l.o.

Kaisar Bagli, Lucknow

M. L., a male child, eleven years of age, brought in on the 1st August, 1934, complaining of defective vision and squint.

Vision?right eye?wearing +3.0 spherical = 6/3G; left eye?wearing -7.0 = 6/24. Left eye?divergent. Cornea?clear in both eyes. Iris tremulous in both eyes, the right much more than the left. Anterior

chamber?right eye outer portion slightly shallower than the rest. Slight signs of an old iritis in both '?yes. Pupil?in both eyes active. In right eye outer

portion showed a greyish convex crescent, looking like u dislocated lens. Left eye?normal.

Under homatropin :? Right eye?lens was markedly dislocated, lying

behind the outer portion of the iris. It was very globular, almost spherical and tags of iris tissue were adherent to its margins on all sides. The lens capsule was greyish white, the lens cortex looked translucent and the lens as a whole had an opalescent appearance. The fundus was highly hypermetropic.

Left eye?the iris was slightly tremulous. The lens was slightly dislocated outwards, the extent of dis- location being such that the portion of pupil occupied by the lens in the right eye was equal to the portion unoccupied in the loft, as illustrated.

The condition of the lens was similar to that in the right eye. There was a double fundus reflex, one

portion highly hypermetropic, the other myopic. In both eyes the vitreous had large floating opacities. Several large white patches of organized wdrite exudates were present in the left eye near the macular.

Retinoscopy :? I +S"0 I 6*0

Right eve ?|? Left eye ?;? | -f?0 | -9-0

The vision was not improved by cylinders and it was found to be -right eye with +6.0 spherical = G/24 & J12 and left eye with -G.0 spherical = G/24 & J4 after the effect of the homatropin had passed off. Binocular vision was not possible.

There was a history of a fall from a roof four or five years previously, but none of any eye trouble following. An ophthalmic surgeon, who saw the child some time after, prescribed only glasses, but did not mention to the father any dislocation of the lens.

Right ?ye Left Eye