Anterior dislocation of the small diameter lens may cause acute pupillary block glaucoma. Mydriatics are used to resolve this attack contrary to the use of miotics in an acute angle closure glaucoma episode, hence termed as inverse pupillary block glaucoma. Note the dilated…

Radially oriented zonular fibers with central extension beyond the normal anterior lens insertion zone.

A 79-year-old woman presents for a routine eye examination, complaining of blurred unaided vision for far on her left eye. She had cataract surgery performed on both eyes 10 years before at a local eye hospital. Except for the retained lens cortical matter, there were no oth…

A 12-year-old was referred for photophobia. The exam resulted in 20/20 vision in both eyes and there was a central cluster of stellate, “snowflake”-like, pigmented deposits on the anterior lens capsule in the left eye. The right eye was within normal limits. The patient sur…

On dilated pupil in retroillumination we will identify trifocal and multifocal IOL respectively.

Visual field before and after cataract surgery. Media opacity such as cataract can impair the visual field. A, An abnormal Humphrey visual field in a glaucoma patient with a dense cataract. B, Improved Humphrey visual field following cataract removal and lens implantation.

A 50-year-old man, with an ophthalmic history of bilateral blindness due to traumatic optic neuropathy after a suicide attempt 30 years ago, presented to the ophthalmology clinic with a new “white stain” in his right eye noticed by his caregiver. The patient denied any ocula…

Illustration of intrascleral glued haptic IOL fixation. A, Scleral flaps are created 180 degrees apart. Intrascleral Scharioth tunnels are created parallel to the limbus with a bent 26-gauge needle. B, A 3-piece foldable IOL is injected into the eye while a microforceps is u…

Late postoperative capsular block. Arrows show the posterior edge of the IOL and the posterior capsule containing turbid fluid.

Transillumination defects of the iris from sulcus placement of a uniplanar 1-piece acrylic IOL. An arrow points out the optic edge; an arrowhead denotes the haptic edge.

Pupillary capture by an angulated posterior chamber IOL in a patient who was assaulted 2 months after lens implantation surgery.

Fibrous ingrowth. A, Clinical photograph. B, Slit-lamp photograph.

Epithelial ingrowth. A, Clinical photograph shows extent of epithelial ingrowth (arrows). B, Slit-lamp photograph shows anterior extent of epithelial ingrowth (arrows).

Descemet membrane detachment. A, Optical coherence tomography (OCT) of the anterior segment. Note the epithelial bullae (arrow) anterior to detachment (arrowhead). B, Slit-lamp photograph of corneal edema superiorly (arrow)/ The detached membrane is reflected inferiorly ((ar…

Iridodialysis repair.

Nuclear cataracts are seen as a central opacity on slit lamp examination and progress slowly and are bilateral. As the lens nucleus becomes harder the index of refraction increases and leads to a myopic shift. Second sight refers to hyperopic presbyopic individuals becoming…

When the entire cortex from the capsule to the nucleus becomes white and opaque the cataract is said to be mature.

This photo presents a case with a subluxated crystalline lens in the left eye of a 45-year-old male taken under a surgical microscope. The crystalline lens is slightly shifted upwards with zonules attached to the lens equator creating a serrated or ridged appearance.

Posterior capsular opacification (PCO) with multifocal PCIOL is the most common complication of cataract surgery and is effectively treated with laser capsulotomy..

Groups of adult nuclear secondary fiber cells (N = 25 secondary fiber cells). Imaginary pole is included to facilitate perception of lens shape. (A) Opposite end curvature of adult nuclear and cortical fibers is less pronounced than in fetal nuclear secondary fibers. (B) Arr…

Conclusion of phaco-chop technique (horizontal chop). (A) As chopping instrument nears handpiece tip, surgeon moves them in opposite directions, horizontally splitting nucleus in two halves. (B) Two halves are rotated slightly. Chopping of heminucleus into smaller fragment b…

Capsular tension ring together with IOL, implanted into isolated capsular bag, maintaining circular shape.

Mature cataract. A cataract is called mature when the lens is totally opacified. A red reflex cannot be obtained; the pupil appears white. The radial spokes in this figure reflect variations in density of the radially arranged fibers in the cortical layers of the lens. Light…

Bimanual laser photolysis procedure. Probe a left delivers infusion; probe at right delivers laser aspiration.

Hand-over-hand technique for introduction of capsular tension ring. (A) Ring is introduced under edge of anterior capsular rim in area of zonular dehiscence. (B) Ring is pushed under anterior capsular rim toward capsular equator. (C) Ring is slowly introduced under anterior…