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

PATIENT

Presentation of a 75-year-old female with subconjunctival lens luxation, that was initially misdiagnosed as conjunctival cyst. Initial examination had been difficult due to vascularized stromal corneal scars and a large hyphema. The ocular history revealed an ocular contusion 11 months ago. Aphakia with subconjunctival lens luxation, iris incarceration, iridodialysis and covered scleral rupture were diagnosed by inspection, palpation, slit-lamp biomicroscopy, gonioscopy and ultrasound biomicroscopy. The lens and incarcerated iris tissue were removed, the scleral wound was sutured and a penetrating keratoplasty was performed in combination with anterior vitrectomy and implantation of a transclerally sutured posterior chamber lens. The histologic investigation of the subconjunctival tissue showed the complete lens with intact lens capsule and surrounding subconjunctival connective tissue.

CONCLUSION

Hyphemas following ocular contusion are frequent findings. A large hyphema may masquerade alterations of other ocular structures. The differential diagnosis of posttraumatic prominent conjunctival "tumors" should include subconjunctival luxation of the lens.