- Medically Reviewed by Mr Mfazo Hove Consultant Ophthalmologist
- Author: Chris Dunnington
- Published: December 23, 2024
Phacodonesis is a complex eye condition that can significantly impact one’s vision and overall eye health. At Blue Fin Vision® Eye Clinic, located on Harley Street in London, we believe in empowering our patients with knowledge about various eye conditions. In this comprehensive guide, we’ll explore phacodonesis, its causes, symptoms, and treatment options.
Understanding Phacodonesis
Phacodonesis is characterised by the tremulousness or vibration of the lens within the eye. This condition often occurs due to lens subluxation or partial dislocation, which can lead to various visual disturbances. The term ‘phacodonesis’ comes from the Greek words ‘phakos’ meaning lens and ‘doneo’ meaning to shake, aptly describing the trembling movement of the lens.
Causes of Phacodonesis
Phacodonesis primarily results from the weakening or breakage of the zonular fibres that hold the lens in place. Several factors can contribute to this condition:
Trauma
Physical injury to the eye can damage the zonules, leading to phacodonesis. Even if phacodonesis isn’t immediately apparent after trauma, patients may be at higher risk of developing progressive zonular dehiscence over time.
Genetic Conditions
Certain genetic disorders can predispose individuals to zonular weakness. These include:
- Marfan Syndrome: A connective tissue disorder that can affect various parts of the body, including the eyes.
- Pseudoexfoliation Syndrome: A condition characterised by the production and accumulation of abnormal fibrillar material in various ocular tissues.
Ageing
As we age, the zonular fibres can naturally weaken, potentially leading to phacodonesis. This is why the condition is more commonly observed in older individuals.
High Myopia
Pathologic axial myopia, a condition where the eye is abnormally elongated, can be associated with acquired lens dislocation and phacodonesis.
Symptoms of Phacodonesis
The symptoms of phacodonesis can vary depending on the severity of the lens displacement. Common symptoms include:
Decreased Vision
This can occur due to refractive changes or lens dislocation. Patients may experience:
- Blurred vision
- Difficulty focusing on objects
- Changes in visual acuity
Glare and Halos
Patients often report increased sensitivity to light, especially noticeable in bright environments. This can manifest as:
- Difficulty driving at night
- Discomfort in well-lit areas
- Seeing halos around light sources
Monocular Diplopia
This refers to double vision in one eye, which can be particularly disorienting for patients.
Eye Pain
In cases where there is associated inflammation or increased intraocular pressure, patients may experience discomfort or pain in the affected eye.
Astigmatism
The displacement of the lens can lead to acquired astigmatism, causing distorted vision.
Diagnosing and Managing Phacodonesis at Blue Fin Vision® Eye Clinic
At Blue Fin Vision® Eye Clinic, we understand the complexities of phacodonesis and its significant impact on eye surgery outcomes. Our expert ophthalmologists employ a range of advanced diagnostic techniques to ensure precise identification and tailored treatment planning for this condition.
Comprehensive Diagnostic Approach
Our thorough diagnostic process includes:
- Comprehensive Eye Examination: Our specialists meticulously assess for key indicators such as iridodonesis (iris trembling), visible lens movement, and changes in anterior chamber depth.
- Slit-Lamp Examination: This provides a detailed view of the eye’s structures, allowing for accurate assessment of lens movement and associated conditions.
- Ultrasound Biomicroscopy (UBM): We utilise UBM to capture detailed images of the eye’s anterior segment, enabling precise evaluation of zonules and lens position.
- Optical Coherence Tomography (OCT): This advanced imaging technique helps us evaluate the retina and optic nerve, which may be affected by lens instability.
Expert Management of Complex Cases
Phacodonesis is a critical risk factor that significantly increases the likelihood of surgical complications. At Blue Fin Vision®, we excel in managing these complex cases:
- Comprehensive Planning: We meticulously prepare for various scenarios, including the potential need for intracapsular lenses, sulcus lenses, and scleral-fixated or anterior chamber intraocular lens options.
- Experienced Team: Our surgeons have extensive experience in handling challenging phacodonesis cases, ensuring the best possible outcomes for our patients.
- Tailored Lens Options: We offer a range of solutions, including sulcus-based monofocal lenses with the option of subsequent Sulcoflex Trifocal implants for patients desiring premium lens options.
Personalised Care and Communication
We pride ourselves on providing clear, detailed explanations of all available lens options and surgical approaches. Our team takes the time to discuss the benefits and considerations of each choice, ensuring you’re fully informed and comfortable with your treatment plan.
Treatment Options for Phacodonesis
The treatment for phacodonesis focuses on stabilising the lens and addressing any underlying causes. At Blue Fin Vision® Eye Clinic, we offer a range of treatment options tailored to each patient’s specific needs:
Surgical Intervention
In many cases, surgical intervention is necessary to address phacodonesis effectively. Options include:
Cataract Extraction with Intraocular Lens Implantation
This procedure involves removing the unstable natural lens and replacing it with an artificial intraocular lens (IOL). Special techniques may be employed to ensure the stability of the IOL in cases of zonular weakness.
Use of Capsular Tension Rings (CTR)
CTRs can be used to stabilise the capsular bag during cataract surgery, providing additional support to weakened zonules.
Scleral Fixation of IOL
In cases where the capsular support is insufficient, the IOL may be fixed to the sclera (the white part of the eye) for added stability.
Modified Capsular Tension Devices
Devices such as the Ahmed Capsular Tension Segment or the Cionni Ring may be used in cases of more severe zonular weakness.
Monitoring and Management
For milder cases or when surgery is not immediately indicated, regular monitoring may be recommended. This includes:
- Regular eye examinations to track the progression of the condition
- Management of associated symptoms through medication or lifestyle adjustments
Preventing Complications
Proper management of phacodonesis is crucial to prevent potential complications such as:
- Complete lens dislocation
- Glaucoma
- Retinal detachment
Our team at Blue Fin Vision® Eye Clinic is experienced in managing these complex cases and minimising the risk of complications.
Living with Phacodonesis
While phacodonesis can be a challenging condition, with proper care and management, many patients can maintain good vision and eye health. We recommend:
- Regular follow-up appointments to monitor the condition
- Adhering to prescribed treatments and medications
- Being aware of any changes in vision and reporting them promptly
- Protecting the eyes from further trauma or injury
Why Choose Blue Fin Vision® Eye Clinic for Phacodonesis Treatment?
At Blue Fin Vision® Eye Clinic, located on prestigious Harley Street in London, we offer:
- Expert Care: Our team of highly skilled ophthalmologists has extensive experience in diagnosing and treating complex eye conditions like phacodonesis.
- Advanced Technology: We utilise state-of-the-art diagnostic and surgical equipment to ensure the best possible outcomes for our patients.
- Personalised Treatment Plans: We understand that each case of phacodonesis is unique, and we tailor our treatment approaches to meet individual patient needs.
- Comprehensive Care: From initial diagnosis through to treatment and follow-up care, we provide comprehensive support throughout your eye health journey.
Conclusion
Phacodonesis is a serious eye condition that requires professional attention. At Blue Fin Vision® Eye Clinic, we provide comprehensive care for all eye conditions, including phacodonesis. Our team of experts on Harley Street in London is committed to helping you maintain optimal eye health and vision.
If you experience any symptoms of phacodonesis or have concerns about your eye health, we invite you to schedule a consultation with our specialists. Early diagnosis and treatment can make a significant difference in managing this condition and preserving your vision.
Remember, your vision is precious, and at Blue Fin Vision® Eye Clinic, we’re here to help you see clearly and live fully. Don’t hesitate to reach out to us for any of your eye care needs.
