LONDON: An Indian-origin surgeon and his colleagues have found a lodged in a woman‘s eye for 28 years.
Dr Sirjhun Patel and his eye specialist colleagues, Lai-Ling Tan and Helen Murgatroyd, recounted the discovery in the ‘British Medical Journal‘ (BMJ) this week, explaining how the 42-year-old patient had presumed the lens had fallen out but had instead moved behind her eye without causing any obvious symptoms for many years.
It was discovered by Patel and his team in Dundee, Scotland, after she complained of swelling recently.
“The patient assumed the lens fell out and was lost; however, it can be inferred that the lens migrated into the eyelid and resided there,” Patel writes in the journal.
“During surgery, an encapsulated cyst was found. On removal, the cyst ruptured and a hard lens was extracted,” he said.
T2-weighted MRI scan of the head: transverse and sagittal views. Red arrows show high-intensity signal nodular lesion in the left upper eyelid. (Photo source: BMJ Case Reports)
It emerged that the patient had been hit in the face by a shuttlecock during a game of badminton as a teenager, when she presumed the lens in her left eye had fallen out.
Patel and his fellow surgeons write: “On further questioning, the patient‘s mother recalled that the patient had a history of blunt trauma to the upper left eyelid as a child.
“The patient was hit in the left eye with a shuttlecock while playing badminton at the age of 14. The patient was wearing an RGP (Rigid Gas Permeable) lens at the time, which was never found.
“It was assumed that the lens dislodged out of the eye and was lost.”
Experts from , carried out an MRI scan after the woman was referred to the Department of Ophthalmology by her general practitioner (GP). She presented with left upper eyelid swelling and ptosis, or a droopy eyelid. Images revealed an ovoid-shaped cyst about 8mm long but there was no evidence of anything inside it. When surgeons removed the lump, the cyst ruptured revealing the lens.
The ‘BMJ‘ paper explains the woman, whose identity is being withheld, suffered swelling to her eye after the incident but that inflammation was successfully treated by her GP. The patient had never worn RGP lenses again following the accident.
The researchers said: “We can infer that the RGP lens migrated into the patient‘s left upper eyelid at the time of trauma and had been in situ for the last 28 years.
“The migration of a rigid gas permeable (RGP) lens into the eyelid is a rare cause of eyelid swelling. Spontaneous migration of a hard lens into the eyelid is a relatively known occurrence, but we were only able to find four reported cases of lens migration secondary to significant trauma.
“This case report exhibits the longest time between traumatic RGP lens migration into the eyelid and presentation of eyelid swelling.”
The patient has since made a complete recovery and there has been no damage to her vision.
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