Rare Case of Traumatic dislocation of iris into vitreous cavity with intact lens

Traumatic aniridia occurs when the iris is extruded from the eye and is often accompanied by lens injuries. Researchers have  reported a rare case of Traumatic dislocation of iris into vitreous cavity with intact lens and the same has been published in BMC Ophthalmology. 

A 30-year-old man has presented a case of traumatic aniridia due to the dislocation of the iris into the vitreous cavity without any damage to the lens. Traumatic aniridia, a rare condition where the iris is extruded from the eye due to severe injury, is typically accompanied by lens injuries. However, this unique case reported in the BMC Ophthalmology has perplexed ophthalmologists as it marks the first reported instance of traumatic aniridia resulting from iris dislocation into the vitreous cavity while leaving the lens unscathed.

The incident came to light when the patient sought medical attention after sustaining an eye injury from a thin wire. The individual complained of visual impairment and pain shortly after the injury. Medical examinations revealed a full-thickness corneal laceration measuring 2 mm, alongside a complete hyphema, a condition where blood accumulates in the front chamber of the eye. Surprisingly, the lens remained intact, the retina appeared healthy, and the majority of the iris tissue was found within the vitreous cavity after the hyphema resolved.

Further investigations disclosed that the iris had found its path to the vitreous cavity through a defect in the zonule, the fibrous structure that holds the lens in place. This unique course of the iris has baffled experts, as common understanding would expect the iris to be extruded from the eye due to the corneal laceration. Over the course of 50 days, the vitreous cavity began accumulating pigment granules and opacity, prompting the necessity for a vitrectomy – a surgical procedure to remove the dislocated iris.

Medical professionals managing the case highlighted the distinct nature of this occurrence. They emphasized that the specific type of injury, the mechanism of trauma, and the force applied might have collectively contributed to this unparalleled condition. Strikingly, instead of resorting to artificial irises, which are a common solution in cases of aniridia, tinted glasses were deemed a more suitable treatment for the patient.

Additionally, the case underscores the importance of peripheral retinal examination in such situations, aiding in accurate diagnosis and management. This isolated case will undoubtedly encourage further research into the intricacies of ocular trauma and broaden the medical community's understanding of traumatic aniridia.

Reference:

Xie, H.-N., Chen, L.-L., Wang, R., Zhu, Z.-H., & Huang, H.-B. (2023). Traumatic dislocation of the iris into the vitreous cavity with intact lens: a case report. In BMC Ophthalmology (Vol. 23, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12886-023-03105-x