Evaluation and management of the patient with subluxated lenses

Abstract

Patients with subluxated lenses present a number of diagnostic and therapeutic challenges. In addition to ascertaining the effect of the lens subluxation on vision and planning the appropriate treatment, one must determine whether there is an associated underlying systemic disorder or whether the subluxation is the result of an inherited purely ocular disease or the result of an injury or malformative process. Underlying systemic disorders can have serious cardiac and other organ involvement and need to be managed by a team of subspecialists best coordinated by a clinical geneticist. Ophthalmic management includes the correction of errors of refraction, the screening for and sometimes the treatment of glaucoma, the therapy of associated amblyopia and strabismus, and, in some cases, lens extraction and the management of the resulting aphakia. This chapter provides an algorithm for the diagnosis and management of such patients as well as some information on the clinical findings and genetics of associated systemic and ocular diseases.