Case description
A 25 years old girl presented with recent onset deterioration of vision
in the left eye (OS) in our OPD. She gave the history of trauma with the
stick in OS 2 months back. Best Corrected Visual Acuity (BCVA) was hand
movements in the right eye (OD) and no Perception of light (No PL) in
OS. Intraocular pressure was 14 mmHg OD and 4 mmHg OS. Detailed anterior
segment examination in OD revealed horizontal jerky nystagmus, inferior
iris coloboma, keyhole pupil, and focal cataractous changes (Figure 1a).
Ocular examination of OS revealed horizontal jerky nystagmus,
circumciliary congestion, shallow anterior chamber, multiple sphinter
tears with atrophic iris, irregular pupil, and cataractous lens with
numerous discrete blood vessels over the lens capsule (Figure 1b).
Fundoscopy in OD revealed chorioretinal coloboma involving the disc and
macula (Figure 1c) and was obscured in OS secondary to traumatic
cataract. Ultrasound B scan depicted lens echoes and moderate to high
reflective membranous echoes attached to optic nerve head posteriorly
and posterior aspect of lens anteriorly. The membranous echoes in the
posterior segment showed limited mobility (Figure 1d). A diagnosis of
iris coloboma, focal cataract, and chorioretinal coloboma was made in
OD, and iris coloboma, lens neovascularization, traumatic cataract, and
retinal detachment were made in OS. This is a very rare and probably the
first case of coloboma, cataract, retinal detachment, and lens
neovascularization. Surgical intervention was not considered in either
eye in view of poor visual prognosis.
Ocular trauma is one of the major yet unrecognized causes of vision loss
globally. The complications of blunt ocular trauma like corneal edema,
keratitis, hyphema, secondary glaucoma, cataract, and retinal detachment
are well known.1. Neovascularization has been reported
in various ocular structures like cornea, iris, anterior chamber angle,
retina, and rarely in the lenticular stroma. But lens neovascularization
has rarely been reported.2