What does bilateral (b/l) downward dislocation of lenses mean?

From the Guidelines

B/L downward dislocated lenses refers to bilateral lenses that have moved downward from their normal position, a condition often associated with genetic disorders like Marfan syndrome, as noted in the 2010 guidelines for the diagnosis and management of patients with thoracic aortic disease 1. This condition, called lens subluxation or dislocation, occurs when the zonular fibers that hold the lens in place become weakened or broken. The "b/l" abbreviation stands for bilateral, and "downward" indicates the direction of displacement. Some key points to consider about this condition include:

• It can cause significant vision problems, including blurry vision, double vision, or seeing the edge of the lens.
• Common causes, aside from Marfan syndrome, include trauma, genetic disorders like homocystinuria, advanced age, previous eye surgery, or high myopia, as discussed in the context of Marfan syndrome's effects on the ocular system 1.
• Symptoms may include sudden vision changes, eye pain, or seeing the edge of the lens.
• Treatment depends on the severity and may include specialized glasses, contact lenses, or surgical intervention to remove or reposition the dislocated lenses. Given the potential for serious complications such as glaucoma, retinal detachment, or vision loss if left untreated, it is crucial to seek immediate ophthalmological care if symptoms of lens dislocation occur.

From the Research

Definition of Dislocated Lenses

• Dislocated lenses, also known as ectopia lentis, refer to a condition where the lens of the eye is displaced from its normal position 2.
• This condition can be caused by various factors, including systemic diseases such as Marfan syndrome, homocystinuria, and Weill-Marchesani syndrome 2, 3.

Types of Dislocated Lenses

• Dislocated lenses can be classified into different types, including:
  • Bilateral (b/l) downward dislocation: This type of dislocation occurs when both lenses are displaced downward 2.
  • In-the-bag dislocation: This type of dislocation occurs when the lens is displaced within the capsular bag 4.
  • Out-of-the-bag dislocation: This type of dislocation occurs when the lens is displaced outside the capsular bag 4.

Causes of Dislocated Lenses

• Systemic diseases such as:
  • Marfan syndrome 2, 5, 3.
  • Homocystinuria 2, 3.
  • Weill-Marchesani syndrome 2, 3.
• Trauma to the eye 4.
• Pseudoexfoliation 4.

Treatment of Dislocated Lenses

• Surgical treatment options include:
  • Lens repositioning 4, 6.
  • Lens exchange 4, 6.
  • Vitrectomy and intraocular lens implantation 5.
• The choice of treatment depends on the type and severity of the dislocation, as well as the underlying cause 2, 5, 4, 6.