Overview: Under normal circumstances, the lens (lens) by the suspensory ligament of lens hanging in the ciliary body, its center and almost the same visual axis. Due to congenital, trauma or disease and other reasons that some or all of the suspensory ligament of lens defect or amputation, causing an imbalance of the lens suspension or loss of power can lead normal physiological position of the lens left, called ectopic lens (ectopia lentis) .[Cause]
ectopic lens is what causes it?
As part of the lens suspensory ligament of congenital abnormalities is weak, unbalanced traction on the lens, poor development of the lens suspensory ligament toward the opposite direction of the displacement force, known as congenital ectopic lens. It can be as isolated ocular anomalies occur in isolation or with other ocular abnormalities or systemic abnormalities (especially mesodermal systemic bone dysplasia syndrome) associated with. Dayton contusion eye injuries, especially eye is the most common cause of ectopic lens. Spontaneous ectopic lens is for some reason, such as inflammation and degeneration of the suspensory ligament of the lens changes caused by weak or because of the suspensory ligament of the eye disease caused due to mechanical stretch.
(B) the pathogenesis
1. ectopic simple lens more visible genetic predisposition, is often more autosomal dominant, autosomal recessive inheritance for the few, often eye-symmetry. Deformity may be associated with slit-like pupil. Suspensory ligament dysplasia reason is not clear. Although inflammation of the uterus, the ciliary body atrophy neuroectodermal is possible predisposing factors, but the exact mechanism is still unknown. If the defects, etc. associated with uveal extensive ectodermal abnormalities may be associated with the ectodermal disorders.
2. accompanied by other abnormalities of the eye lens of a small ectopic common spherical lens (microspherophakia), lens defects (coloboma of the lens), iris defects (iris coloboma), aniridia syndrome (aniridia) and ectopic pupil (ectopia pupillae) and so on.
3. associated with systemic abnormalities of the lens ectopic
(1) Marfan syndrome: a common autosomal dominant disease, manifested as widespread systemic mesodermal tissue disorders, eye, cardiovascular and skeletal system anomaly. Marfan in 1896 first reported the syndrome. Ectopic eye lens usually different, especially up and to the temporal shift. As the absence of the iris pigment layer could produce after transillumination test was positive, the pupil to open large muscle partial absence of drug difficult to mydriasis. There are also other eye iridocorneal angle abnormalities, and macular choroidal defects, but also produce glaucoma, retinal detachment, nystagmus, strabismus, amblyopia and other complications. Hand, foot and skeletal differences usually slender limbs, long head and long face-lift. Cardiovascular differences usually not Cardiac foramen ovale closure, and aortic aneurysm stenosis. Generally more men than women.
(2) Marchesani syndrome: an autosomal recessive genetic disease. Patients with short stature, limb (toe) short and thick, the normal cardiovascular system. Spherical lens, less than normal, often under the nose of ectopic, prone to glaucoma, often accompanied by a high refractive myopia. Other ocular abnormalities include ptosis, nystagmus, small cornea and so on.
(3) the same type of homocystinuria (homocystinuria): an autosomal recessive genetic disease, most often affect the bones, which is based on osteoporosis and systemic thrombosis tendency is characterized. Ectopic lens more to the bottom of the nose, easy dislocation to the anterior chamber and vitreous cavity. The organizational structure of the lens suspensory ligament and ultrastructural abnormal changes. Eye can also be combined with congenital cataract, retinal detachment and degeneration, aniridia and other abnormalities. Pathogenesis of this disease because of the lack of off sulfide synthase patients, can not make the same type of cysteine into cystine. The following is a comparison of the three syndromes (Table 1).
4. ectopic lens in traumatic contusion of the most common eye Dayton. Trauma can directly lead to the lens suspensory ligament of the incomplete or complete rupture, causing the lens subluxation or dislocation.
5. ectopic spontaneous lens caused due to inflammation and degeneration of the suspensory ligament becomes weak or because of the suspensory ligament of the eye disease caused due to mechanical stretch. By the suspensory ligament mechanical stretch-induced ectopic common in the bull's-eye lens, eye, or staphyloma expansion can also be found in the ciliary body or vitreous inflammation, adhesions cord traction lens. Intraocular tumors can push and pull the lens out normal position. Inflammatory destruction of the lens suspensory ligament can be seen in endophthalmitis or the whole eye inflammation, suspensory ligament can be completely decomposed. Chronic inflammation of the ciliary body can rise to the same pathological process, suspended particles ciliary ligament tissue can be accounted for. Suspensory ligament degeneration or dystrophy is the most common cause of spontaneous dislocation, often accompanied by vitreous degeneration and liquefaction, such as high myopia, old choroiditis or iridocyclitis, retinal detachment. Iron or Bronze calm psychosis gradual degeneration suspensory ligament can also break down. Another common cause is too senile cataract maturity, variability, changes involving the lens suspensory ligament of lens. Once the suspensory ligament degeneration, the lens may be because of their weight or even minor trauma and hard cough can occur at any time spontaneous ectopic.[Sign]
What are the early symptoms of ectopic lens?
1. suspensory ligament of lens subluxation lens or some relaxation away from the off, so that deviation from the normal physiological position of the lens, but the shift of the lens is still the pupil, the iris plane vitreous cavity, known as lens subluxation. Lens subluxation lens resulting symptoms depend on the extent of displacement. If the lens is still, as the shaft axis, only occur due to suspensory ligament laxity, increased lens curvature of the lens caused by myopia. Occur if the level of the lens axis, vertical or oblique nature of tilt can lead to difficult with glasses or contact lens correction of severe astigmatism. The subluxation is more common vertical lens shift, there may be monocular diplopia. Eye slit-lamp examination showed anterior chamber becomes deeper, the iris tremor, gray lens, or even see the equator suspensory ligament rupture. Can enter the anterior chamber vitreous hernia, surface pigment. Crescent-shaped retinal fundus microscope, reflective and eyes at the end like.
2. luxation of lens suspensory ligament of the lens completely from the off, so that the lens completely left the normal physiological location, rooms or forward displacement of the vitreous cavity, known as lens dislocation. May have the following situations:
(1) incarcerated in the lens pupil.
(2) off into the anterior chamber lens.
(3) off the lens into the vitreous cavity, vitreous float or sink in the glass body.
(4) lens under the retina through the retinal hole into the space and the space under the sclera.
(5) through the lens corneal perforation, scleral rupture into the hole under the conjunctiva or Tenon.
lens luxation more serious consequences than the subluxation. Lens can be incarcerated in the pupil caused by pupillary block, lens trauma often occurs in the axis of rotation 90 °, the equator of the lens in the lens pupil area and even 180 ° transposition, anterior surface of the vitreous.
lens completely left the pupil area, the visual equivalent of aphakic visual acuity, anterior chamber becomes deeper, iris tremor, early dislocation of the lens can move along with postural changes occur. If the lens off into the anterior chamber, will sink to the bottom of variable depth of anterior chamber, lens diameter smaller than in the normal position, convexity increases. Oil droplets were transparent lens-like, marginal zone golden gloss, opacity of the lens was a white plate tilting. Lens from the vitreous cavity through the pupil into the anterior chamber during off some pupillary block can occur, causing acute glaucoma. If the pupil area clear, and can maintain good vision, the patient can be better tolerated. Sometimes the cataract hypermature off into the anterior chamber lens may be due to improve vision, anterior chamber lens can be gradually absorbed. But more often the lens and the cornea and iris and ciliary repeated exposure to cause severe iridocyclitis, corneal dystrophy and acute glaucoma. Off the lens into the vitreous cavity into the anterior chamber common than off, and the patient can be better tolerated, but the final outcome is still the problem.
based on clinical manifestations and eye symptoms, diagnosis is not difficult.[Aftertreat]
ectopic lens ate?[Prevent]
ectopic lens should be how to prevent?
to prevent eye injury, and actively deal with primary eye disease.[Treat]
ectopic lens to consider before treatment?
ectopic lens treatment is difficult. Because removal of the ectopic lens cataract risk than the general blind eye surgery may cause eye damage and even loss. Therefore, treatment should be carefully decided. Lens depends on the treatment of ectopic lens position, lens hardness, the risk of eye sight and vision fellow eye; age, with or without congenital anomalies, with or without complications and surgical conditions. Ectopic lens vision loss caused by many reasons, such as refractive media opacities, secondary glaucoma, congenital retinal disorders, cataract extraction surgery therefore does not necessarily improve their eyesight. For no complications lens subluxation, the treatment approach is to use glasses or contact lens correction lens with lens zone or zones of refractive errors and restore proper vision. Because most of the lens area of irregular astigmatism, often difficult to correct, without the lens area of the optical correction often get better results. If there is no small lens area, while deep anterior chamber, will be available weak mydriatic pupil continued dilated, or laser iridotomy, lens-free zone increases, which will help non-refractive lens area. Generally believed that the indications for surgical removal of the lens:
1. Ectopic serious damage to eye lens, especially those associated with cataracts.
2. off the lens into the anterior chamber.
3. lens soluble glaucoma.
4. lens allergic uveitis.
5. pupillary block glaucoma after conservative treatment or surgery alone can not reduce the intraocular pressure of glaucoma.
6. lens opacity impede the examination and retinal detachment surgery.
7. ectopic lens too ripe or mature cataract stage.
(b) the prognosis
dislocation of the lens of the outcomes vary. Dislocation of the lens can be a lot of years to be transparent. But always to the degeneration of the lens dislocation direction. Epithelial cells gradually break down, the water splitting to form the cortex, cortical opacities after liquefaction, lens capsule shrinkage and nuclear sinking form Mogan (Morgagnian) cataract, partial and full absorption is less common. In case of serious complications, removal of the dislocation of the lens can not improve vision.
Chinese medicine treatment of ectopic lens
ectopic lens of Western medicine treatment
ectopic lens should do the check?
1. genetic testing in suspected congenital ectopic lens can be carried out to confirm the diagnosis.
2. blood, urine check whether they contain the same type of clear cystine (homocystinuria), to exclude the same type of homocystinuria.
1.B ultrasound complete dislocation of the lens can not clear their position, can be used for B-eye look.
2. clear color Doppler cardiac valvular disease and hemodynamic conditions.[Diff]
lens ectopic diseases easily confused?
currently no related content description.[Disease]
tension headaches may be caused by the diseases?
tension headache-related diseases
deficiency disease, migraine headache, head wind
more head symptoms
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