Our patient is a 47-year-old male with a history of myotonic muscular dystrophy and bilateral cataract extraction with implantation of intraocular lens. This was complicated by the development of bilateral dense posterior capsular opacities that were resistant to YAG capsulotomy (attempted twice in the right eye prior to this presentation). He presented with 2 days of “a line in my vision that changes angles when I move my head.” During the slit lamp exam, he was noted to have a large Elschnig pearl suspended in his central visual axis which swung with his eye movements as demonstrated in the video above.
This variety of aftercataract occurs typically in eyes with very little or no postoperative inflammation. It is due to random proliferation of the cells which produce lens fibres, along the posterior capsule.These aborted lens fibres glisten like precious stones in retroillumination.
Ophthalmic Atlas Images by EyeRounds.org, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.
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