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PHOTO ESSAY
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 395-396

Atypical bilateral isolated coloboma of the lens with cataract in a young man


Cataract and Refractive Services, L V Prasad Eye Institute, Banjara Hill, Hyderabad, Telangana, India

Date of Submission19-Dec-2020
Date of Acceptance04-Mar-2021
Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Vivek Mahendra Singh
L V Prasad Eye Institute, Kallam Anji Reddy Campus, Banjara Hills Road No. 2, Hyderabad, Telangana . 500 034
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3649_20

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  Abstract 


Keywords: Atypical coloboma, posterior subcapsular cataract (PSC)


How to cite this article:
Priya C T, Singh VM, Reddy C J. Atypical bilateral isolated coloboma of the lens with cataract in a young man. Indian J Ophthalmol Case Rep 2021;1:395-6

How to cite this URL:
Priya C T, Singh VM, Reddy C J. Atypical bilateral isolated coloboma of the lens with cataract in a young man. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 28];1:395-6. Available from: https://www.ijoreports.in/text.asp?2021/1/3/395/320082



A 26-year-old male presented to our clinic with complaints of gradual progressive diminution of vision in the left eye for 6 months and no other significant positive history was present. On ocular examination, the unaided visual acuity in the right eye (RE) was 20/20 but 20/100 in the left eye (LE). On dilated slit-lamp examination, RE showed a central trace posterior subcapsular cataract (PSC) along with a lens coloboma at 3' 0 clock hour (nasal), which became more obvious on retro illumination [Figure 1]a and [Figure 1]b. LE, had denser PSC and larger coloboma, extending from 2.5 to 4'0 clock hour (temporal) [Figure 1]c and [Figure 1]d. The iris morphology in both eyes was normal with no clinically appreciable iridodonesis or phacodonesis. In the LE, ciliary processes were visible in the region of lens coloboma [Figure 2]. Fundus examination had no evidence of coloboma, and also no significant findings were found on systemic examination.
Figure 1: Atypical lenticular colobomas of both eyes. Figure 1 shows nasal coloboma of the right eye at 3' 0 clock hour with trace PSC (a) and temporal coloboma of the left eye extending from 2.5 to 4'0 clock hour with dense PSC (d). Figure (b and c) show the Scheimpflug image of the right and left eye, respectively, with absent zonules leading to rounding of lens margin (yellow arrow)

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Figure 2: Shows the visible ciliary processes in the left eye at the edge of the coloboma (yellow arrowhead)

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  Discussion Top


Coloboma of the lens is a rare congenital anomaly wherein there is a presence of a notch at the equator of the lens. It can either occur in isolation or association with other ocular malformations due to the failure of the fetal fissure to close completely.[1],[2] It is mostly unilateral; however, bilateral cases also have been reported.[2] Notching of the lens typically presents inferonasally at the site of the closure of embryonic fissure, but the atypical coloboma may occur anywhere along the circumference of the lens.[1],[2]

As the etiology of atypical coloboma is unclear, few theories suggest that it might be due to the rotation of embryonic fetal fissure while others hypothesize that it may be a consequence of an inflammatory reaction.[3] Thus, we present this unusual case of bilateral lens coloboma at an atypical site without any iris abnormality or retinochoroidal coloboma, unlike most of the cases reported earlier.[4]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Hyderabad Eye Research Foundation (HERF).

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Onwochei BC, Simon JW, Bateman JB, Couture KC, Mir E. Ocular colobomata. Surv Ophthalmol 2000;43:175-94.  Back to cited text no. 1
    
2.
Bavbek T, Ogut MS, Kazokoglu H. Congenital lens coloboma and associated pathologies. Doc Ophthalmol 1993;83:313-22.  Back to cited text no. 2
    
3.
Barber AN. Embryology of the lens. In: Barber AN, editor. Embryology of the Human Eye. St Louis: CV Mosby; 1955. p. 50-63.  Back to cited text no. 3
    
4.
Ozanics V, Jacobiec FA. Ocular anatomy, embryology and teratology. In: Jacobiec FA, editor. Prenatal Development of the Eye and Its Adnexa. Philadelphia: Harper & Row; 1982. p. 11-9.  Back to cited text no. 4
    


    Figures

  [Figure 1], [Figure 2]



 

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