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Case study: Lightning strikes twice

Clinical Practice
The first entry to our case study competition is Tim Woolley for his photographic recording of a patient requiring repeat urgent referral

VISIT ONE

A male patient in his mid-sixties attended (under PEARS/MECS scheme) because his left eye had become ‘blurred’. This seemed to be related to him ‘hitting the eye with a Hoover’ approximately two weeks previously.

Presentation

Examination

Examination of the left eye showed a band of capsular tissue across the pupil (figure 1). The anterior chamber was of normal depth and so he was dilated with tropicamide.

Post-dilation examination showed the IOL was displaced. He was somewhat photophobic making examination slightly difficult.

Despite this, there was evidence that the capsule had also ruptured. There was also pigment in the AC, with what appeared to be displaced vitreous (figure 2). I suspected this was related to the trauma.

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