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A healthy 69-year-old man underwent cataract surgery and elected to have a multifocal intraocular lens placed in his left eye. At the one-week postoperative visit, his uncorrected distance visual acuity was 20/20, and he was pleased with his near vision, though it was not formally checked. The following Friday, the patient slept outside because it “was a balmy night.” Unfortunately, he stepped on a loose rock and fell on his left side, striking his eye.
When the patient presented on Saturday morning, the vision in his left eye had declined to light perception, intraocular pressure was 26 mmHg, and the anterior chamber was full of blood. Two days later, the hemorrhage cleared to reveal traumatic aniridia, and the IOP climbed to 62 mmHg. In this image, strands of superior iris are connected to the hemorrhage at the 6 o’clock position. Once the heme cleared, the remaining iris was nowhere to be found. The IOL remained in the eye, although it appeared to have shifted slightly temporally.
The patient went on to have an Ahmed valve implantation, and his vision continued to improve as the vitreous and anterior chamber blood cleared. He was 20/40 at last follow-up, three months after the fall.
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