Complete Dislocation of the Lens of the Eye - Always Review the Complete Study

Abstract

This 37 year-old male patient underwent high resolution CT imaging of the face including paranasal sinuses following trauma. Computed tomography (CT) has a well-established role in the assessment of the facial bones in the context of trauma, in particular for fractures involving the paranasal sinuses and orbit. High resolution imaging permits isotropic reconstruction in multiple planes. Its use in imaging the contents of orbit itself is more select, with both direct clinical examination and even orbital ultrasound used to assess the globe and lens of the eye.¹

Traumatic dislocation of the lens of the eye may entail the partial or complete translocation of the lens from its normal position within the anterior aspect of the eye.2 The high attenuation lens ‘floats’, within the vitreous of the globe (Figures 1, 2 and 3).

Following trauma to the face the injuries may be multiple and cross sub-speciality boundaries, but one should be alert to all injuries. In reviewing CT images one should be forensic in the review of all the anatomy covered, even it is not related to the original clinical query or not pertinent to one’s own clinical speciality.

As an old mentor once told me, ‘Before you take the film down, have one last paranoid look.’

Learning Point: Always review the entirety of the imaging performed

despite the focus of one’s clinical or speciality interest.