Evaluation and treatment of traumatic cataract and iris damage

Surgical repair of traumatic cataracts can be challenging due to the extent of damage to ocular structures. While the obvious deformity is the lens opacity, it can be accompanied by other issues such as capsule damage, zonular loss, vitreous prolapse, iris damage, induced glaucoma and more. A careful stepwise approach is best for these tough cases.In the example shown here, a teenage boy was injured with a pellet gun a few weeks prior. Luckily, there was no rupture of the globe, and there was no intraocular or intraorbital foreign body. Still, the damage to the eye was extensive. At his initial presentation, the patient had a near total hyphema that was managed well with conservative therapy. Once the blood cleared from the anterior chamber, he was referred to our medical center for surgical repair. At our teaching hospital, we encounter many traumatic cases such as this, and I was fortunate to have James Sanchez, MD, our chief resident, spearhead the effort to help this child.