Conjunctival cyst: subconjunctival luxation of the lens following ocular contusion - a case report

Patient: Presentation of a 75-year-old female with subconjunctival lens lux ation, that was initially misdiagnosed as conjunctival cyst. Initial examin ation had been difficult due to vascularized stromal corneal scars and a la rge hyphema. The ocular history revealed an ocular contusion 11 months ago. Aphakia with subconjunctival lens luxation; iris incarceration, iridodialy sis and covered scleral rupture were diagnosed by inspection, palpation, sl it-lamp biomicroscopy, gonioscopy and ultrasound biomicroscopy. The lens an d incarcerated iris tissue were removed, the scleral wound was sutured and a penetrating keratoplasty was performed in combination with anterior vitre ctomy and implantation of a transsclerally sutured posterior chamber lens. The histologic investigation of the subconjunctival tissue showed the compl ete lens with intact lens capsule and surrounding subconjunctival connectiv e tissue. Conclusion: Hyphemas following ocular contusion are frequent findings. A la rge hyphema may masquerade alterations of other ocular structures. The diff erential diagnosis of posttraumatic prominent conjunctival "tumors" should include subconjunctival luxation of the lens.