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Aphakia

Aphakia is the absence of the crystalline lens from the eye. It causes high hyperopia and loss of accommodation. Causes include congenital absence, cataract surgery, trauma, or dislocation of the lens. An aphakic eye has high hyperopia, reduced total power, and loss of accommodation. Symptoms are defective vision and signs include a limbal scar, deep anterior chamber, and absent Purkinje images. Treatment options include glasses, contact lenses, or intraocular lens implantation. Glasses cause image magnification and optical aberrations while contact lenses are costly and require maintenance. Intraocular lens implantation is the best method as it corrects vision without other issues.

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907 views12 pages

Aphakia

Aphakia is the absence of the crystalline lens from the eye. It causes high hyperopia and loss of accommodation. Causes include congenital absence, cataract surgery, trauma, or dislocation of the lens. An aphakic eye has high hyperopia, reduced total power, and loss of accommodation. Symptoms are defective vision and signs include a limbal scar, deep anterior chamber, and absent Purkinje images. Treatment options include glasses, contact lenses, or intraocular lens implantation. Glasses cause image magnification and optical aberrations while contact lenses are costly and require maintenance. Intraocular lens implantation is the best method as it corrects vision without other issues.

Uploaded by

ankur_1
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPT, PDF, TXT or read online on Scribd
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Aphakia and its correction

Aphakia
Def: Absence of crystalline lens from the patellar fossa Produces a high degree of hypermetropia and loss of accomodation

Causes
Congenital absence of crystalline lens Surgical aphakia after cataract extraction Post-traumatic absorption of lens Traumatic extrusion of lens Posterior dislocation of lens

Optics of an aphakic eye


High hypermetropia Total power of the eye reduced to +44 D Aphakic eye consists of a curved surface, ie. cornea , separating two media of different refractive indices, air (1) and aqueous and vitreous humor (1.33) Anterior focal point becomes 23.2 mm in front of the anterior surface of the cornea Posterior focal point lies 31 mm behind the anterior surface of the cornea Total loss of accomodation

Clinical features
Symptoms: defective vision for near and far Signs: Limbal scar may be seen in case of surgical aphakia Deep anterior chamber Jet black pupil Iridodonesis Purkinje image test: 3rd and 4th images are absent Fundus examination: small hypermetropic disc

Treatment
Optical treatment: Spectacles: - Standard aphakic glass- +10D - Exact power to be determined by retinoscopy Advantages: safe, easy and inexpensive method of correcting aphakia

Treatment
Difficulties encountered in correcting aphakia with the use of spectacles: - Image magnification of ~30% (cannot be used to correct unilateral aphakia as it will result in diplopia) - Spherical aberrations resulting in pincushion effect - Lack of physical coordination

- Jack in the box phenomenon- roving

ring scotoma due to prismatic effects at the edges of the lens - Prismatic errors resulting from displaced optical centres of lenses - Reduced visual fields and poor eccentric acuity - Physical inconvenience and cosmetic deficiency of heavy spectacle lenses

Contact lenses: Advantages: - Less image magnification - Elimination of aberrations and prismatic effects of thick glasses - Better field of vision - Cosmetically more acceptable - Suitable for unilateral aphakia

Disadvantages of contact lenses: - Costly - Cumbersome to use esp in children and elderly - Associated corneal complications

IOL implantation: best available method of correcting aphakia Refractive corneal surgery: - Keratophakia- lenticule prepared from donor cornea is placed between patients corneal lamellae - Epikeratophakia: a lenticule prepared from the donor cornea is sutured to the surface of patients cornea after removing the epithelium - Hyperopic LASIK

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