IJO Indian Journal of Ophthalmology
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ALL INDIA OPHTHALMOLOGICAL SOCIETY ISSN : 0301-4738 Vol 67, Issue 01, January 2019
139
Ophthalmic Images
January 2019
References 1. Mamalis N. Intraocular lens glistenings. J Cataract Refract Surg 2012;38:1119‑20. 2. Tripathy K. Posterior capsular cyst on anterior segment optical coherence tomography. Ophthalmology 2018;125:1324. 3. Tripathy K, Sharma V. Thin posterior capsule in persistent fetal vasculature causing an appearance of spontaneous posterior capsular rupture. Indian J Ophthalmol 2018;66:1616-7. 4. Werner L. Glistenings and surface light scattering in intraocular lenses. J Cataract Refract Surg 2010;36:1398‑420. Figure 2: The optical coherence tomography delineated intraocular lens glistening as areas of hyperreflectivity within the intraocular lens optic and showed a distended posterior capsule with hyperreflective materials in the space between the intraocular lens and the posterior capsule
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Conflicts of interest There are no conflicts of interest.
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Koushik Tripathy, Uma Sridhar Department of Ophthalmology, ICARE Eye Hospital and Post Graduate Institute, Noida, Uttar Pradesh, India Correspondence to: Dr. Uma Sridhar, ICARE Eye Hospital and Post Graduate Institute, E3A, Sector‑26, Noida ‑ 201 301, Uttar Pradesh, India. E‑mail:
[email protected]
An eye within an eye An 18‑year‑old asymptomatic male visited us for a regular eye check‑up. His best corrected visual acuity was 20/20 in both eyes. Slit‑lamp examination revealed quiet anterior chamber; clear crystalline lens in both eyes; and a spherical, translucent, mobile cyst in the inferior part of anterior chamber of the right eye [Fig. 1a]. His intraocular pressure was 12 mm of Hg in both eye, and fundus examination of
a
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Website: www.ijo.in DOI: 10.4103/ijo.IJO_1031_18 PMID: ***
Cite this article as: Tripathy K, Sridhar U. Optical coherence tomography of intraocular lens glistening. Indian J Ophthalmol 2019;67:138-9.
both the eyes was unremarkable. Anterior segment optical coherence tomography through the inferior cornea from 4 to 7 o’clock hours revealed a prodigious appearance of “An eye within an eye” [Fig. 1b]. Iris cysts in children are uncommon and can pose significant diagnostic and treatment challenge to the treating ophthalmologists.[1] Unlike secondary iris cysts that follow surgical or nonsurgical trauma, primary iris cysts are stationary lesions, which rarely progress or lead to severe complications such as inflammation and glaucoma.[2,3] Primary iris cyst in an asymptomatic child usually does not
b
Figure 1: (a) Slit‑lamp photograph of the right eye showing a spherical, translucent, mobile cyst in the inferior part of anterior chamber. (b) Anterior segment optical coherence tomography through the inferior cornea from 4 to 7 o’clock hours giving an appearance of ‘An eye within an eye’ with iris cyst at the centre
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Indian Journal of Ophthalmology
require any treatment, and unnecessary surgical intervention can lead to increased risk of operative complications during an amblyogenic age.[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 Nil. Conflicts of interest There are no conflicts of interest.
References 1. Shields CL, Kancherla S, Patel J, Vijayvargiya P, Suriano MM, Kolbus E, et al. Clinical survey of 3680 iris tumors based on patient age at presentation. Ophthalmology 2012;119:407‑14. 2. Shields JA, Kline MW, Augsburger JJ. Primary iris cysts: A review of the literature and report of 62 cases. Br J Ophthalmol 1984;68:152‑66. 3. Grutzmacher RD, Lindquist TD, Chittum ME, Bunt‑Milam AH, Kalina RE. Congenital iris cysts. Br J Ophthalmol 1987;71:227‑34. 4. Georgalas I, Petrou P, Papaconstantinou D, Brouzas D, Koutsandrea C, Kanakis M, et al. Iris cysts: A comprehensive review on diagnosis and treatment. Surv Ophthalmol 2018;63:347‑64. This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. Access this article online
Kowsigan Magesan, Parthopratim Dutta Majumder1, Vikas Khetan2
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Department of Optometry, Medical Research Foundations, Sankara Nethralaya, Departments of 1Uvea and 2Vitreoretina, Medical and Vision Research Foundations, Sankara Nethralaya, Chennai, Tamil Nadu, India Correspondence to: Dr. Parthopratim Dutta Majumder, Department of Uvea, Sankara Nethralaya, 18, College Road, Nungambakkam, Chennai ‑ 600 006, Tamil Nadu, India. E‑mail:
[email protected]
Volume 67 Issue 1
Website: www.ijo.in DOI: 10.4103/ijo.IJO_1135_18 PMID: ***
Cite this article as: Magesan K, Majumder PD, Khetan V. An eye within an eye. Indian J Ophthalmol 2019;67:139-40.
Free floating pigmented vitreous cyst A 32‑years‑old female was referred for a mass in her left eye detected on routine examination. The ocular examination was normal with unaided visual acuity of 20/20 in her left eye. There were no signs of ocular trauma/inflammation. A single, pigmented, free‑floating cyst was noted in the anterior vitreous [Fig. 1a and c] that showed speckled bright areas on infrared reflectance imaging [Fig. 1b]. In view of no symptoms, the patient was advised conservative management. These cysts have been reported rarely. These may represent choristoma of the hyaloid vascular system or may originate from ciliary epithelium. Acquired cysts can be found in association with retinoschisis, retinitis pigmentosa, trauma, coloboma, retinal reattachment surgeries and intraocular inflammation.[1,2] Though usually asymptomatic, vitreous cysts can disturb visual function when cyst floats into the visual axis. A period of observation should be recommended before invasive intervention in the form of laser cystotomy or vitrectomy.[3] 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.
a
b
c Figure 1: Fundus colour photograph (a) and ultra-widefield pseudocolour photograph (c) of the left eye of a 32-year-old female showing pigmented vitreous cyst. Infrared imaging shows multiple areas of hyperreflectance over the surface of cyst (b)
