Clinical History of a Case of Sub- 
conjunctival Dislocation of the 
Crystalline Lens. 
- BY - 
CHARLES A. OLIVER, A.M., M.D., 
PHILADELHIA, PA, 
Reprint from Ophthalmic Record. June, 1897. CLINICAL HISTORY OF A CASE OF SUBCONJUNCTIVAL 
DISLOCATION OF THE CRYSTALLINE LENS. * 
By CHARLES A. OLIVER, A. M., M. D , 
One of the Attending Surgeons to the Wills' Eye Hospital ; one of the Ophthalmic Surgeons to 
the Philadelphia and Presbyterian Hospitals, etc. 
R. McA., a thirty-four year old housewife, applied at my clinic at 
the Presbyterian Hospital in Philadelphia with the history that two 
days previously she had fallen and struck her right eye against a pro- 
jecting door-latch. 
At the time of the first examination a lenticular shaped mass 
resting upon a tear in the sclera in the upper inner ciliary region could 
be plainly seen underlying the swollen and chemotic conjunctival 
membrane. The cornea was diffusely hazed and the anterior chamber 
was partly filled with blood. The iris was retracted and tremulous, 
its upper and inner quadrant being dragged out of sight backwards and 
inwards, producing a large coloboma. No fundus-reflex could be 
obtained. 
The patient was admitted to the Hospital and carefully prepared 
for operation, which was done under as strict aseptic conditions as 
possible, by my assistant, Dr. William T. Shoemaker. The patient 
was etherized and the conjunctiva over the lenticular swelling was 
incised so as to allow the mass of unencapsulated lens-material to 
escape and to be extruded by the employment of a grooved spud. The 
scleral wound, which was cleanly cut, was not disturbed, as there was 
not any tendency for the vitreous to prolapse. It was not found 
necessary to place any conjunctival sutures in position. The field of 
* Patient exhibited before the Section on Ophthalmology of the College of Physicians of 
Philadelphia, and paper read before the April, 1897, meeting of the Golden Belt Medical Society. 
2 3 
operation was thoroughly cleaned and protected with an occlusive 
dressing. In a few days the wound healed without a sign of inflam- 
matory reaction. 
At present the eye is perfectly quiet, the scleral scar is firmly 
united and but slightly prominent. The coloboma is unchanged. The 
haze of the cornea and the blood extravasations in the aqueous and 
vitreous humors have disappeared, allowing the undisturbed eye- 
ground to be plainly seen. The remnants of the torn capsule of the 
lens are faintly visible, just behind the upper inner border of the 
pupillary area. Vision with a properly correcting lens has risen to 
nearly normal. 
Remark : -The case is of interest for several reasons : the com- 
parative rarity of the form of accident, the escape of the unencapsulated 
lens-material through the scleral rent into a single subconjunctival 
mass, the almost immediate removal of the lens-material without 
waiting for the tear in the sclerotic to unite, the avoidance of any 
retaining sutures, and the excellent result. Volume VI. New Series. No. 6. 
JUNE, 1897. 
•• • THE••• 
OPHTn/ILnK REQORb 
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