Abstract

A 27 year old man presented with pain and redness in his LE for a month. BCVA was 6/9p in RE and esotropia in LE with NPL. According to him both inward deviation and NPL in the LE were from childhood.
Biomicroscopically the RE was normal, whereas the LE showed conjunctival congestion, band shaped keratopathy inferiorly & multiple highly mobile refractile particles in the AC continuing with similar findings in the anterior vitreous, through the mid-dilated & fixed pupil, while the lens was subluxated inferiorly. IOP of the RE was 17 mm Hg while the LE had hypotony.
A course of topical prednisolone 1% and atropine 1% for one week was given after which lens removal was done with vectis, and followed by anterior vitrectomy to remove the refractive crystals. Aqueous and vitreous taps were sent for cytological analysis: which reported the presence of numerous cholesterol crystals and proteinaceous debris.