Spontaneous absorption of a traumatic cataract

I saw a 9 year old boy in practice who was unilaterally aphakic. He was a refugee with little history to go on.  However, what he could tell me was that the poor vision in his left eye had been caused by a ‘needle in the eye’ when he was very small.

On examination there was a tiny pinpoint scar in the central cornea and no evidence of surgical intervention.

So how had his eye become aphakic?  Where was the lens? Had it become dislocated? No, it was not there at all.

What appeared to have occurred was this.  The needle penetrated the cornea and probably the anterior lens, leaving behind  clean wound which quickly healed.  The following traumatic cataract then became fully reabsorbed over time and the only evidence left was the tiny corneal scar. 

The perfect surgery and one very lucky (or unlucky) child, depending upon which way you look at it.

Images reproduced from Clinical Ophthalmology (J Kanski) with kind permission from Elsevier Health Ltd.

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