Optometric Physician



Vol. 23, #36  •   Tuesday, September 20, 2022


Off the Cuff: Congratulations, California!

The California Optometric Association has succeeded in getting one of the biggest scope expansion bills through their legislative process. This bill includes incisional procedures for lid lesions, injections for chalazia, as well as corneal crosslinking. Additionally, the bill includes the use of lasers for YAG capsulotomies, peripheral iridotomies, and trabeculectomies. If this bill is signed by their governor by the end of the month, it will be a huge win for the patients of California.

Note about Epstein:
unfortunately, no good news to report. Complications from the surgery have landed him back in the hospital. I am amazed at the inner strength he has shown through all these painful tests and procedures. He still has a rather long road ahead.


Shannon L. Steinhäuser, OD, MS, FAAO
Co-Chief Medical Editor

Want to share your perspective?
Write to Dr. Epstein at artepstein@optometricphysician.com. The views expressed in this editorial are solely those of the author and do not necessarily represent the opinions of Jobson Medical Information LLC (JMI), or any other entities or individuals.




Lens Nucleus Dislocation in Hypermature Cataract: Case Report and Literature Review

Hypermature cataract is a form of late-stage cataract progression that can lead to a variety of complications. Spontaneous capsular rupture with lens nucleus displacement in hypermature cataracts has rarely been reported. Researchers described two cases of spontaneous dislocation of the lens nucleus in a hypermature cataract and perform a review of the literature on this complication. They reported on two rural men, ages 50 and 76, with deteriorating vision. The final diagnosis was senile hypermature cataract with dislocation of the lens nucleus in both patients and secondary glaucoma for the second patient.

During admission, both patients complained of deteriorating vision. Slit-lamp examination showed lens nucleus dislocation into the anterior chamber. The 50-year-old patient exhibited a residual lens capsule and a turbid cortex, with a normal anterior chamber and intraocular pressure. The 76-year-old patient presented a shrunken and ruptured capsule and no cortex in the pupillary area, mild inflammation in the anterior chamber, and high intraocular pressure. Both patients underwent intracapsular cataract extraction combined with anterior vitrectomy, and achieved good postoperative recovery.

Researchers wrote that lens nucleus dislocation in hypermature cataracts can be seen in clinical practice, particularly in underdeveloped areas. Early recognition and surgery can improve vision.

SOURCE: Guan JY, Ma YC, Zhu YT, et al. Lens nucleus dislocation in hypermature cataract: Case report and literature review. Medicine (Baltimore). 2022; Sep 2;101(35):e30428.