Aphakia

People with aphakia have relatively small pupils and their pupils dilate to a lesser degree.

Signs and symptoms

• Hypermetropia: Without the focusing power of the lens, the eye becomes very farsighted.
• Loss of accommodation: Since the lens and its zonules are responsible for adjusting the focus of vision to different lengths, patients with aphakia will have a total loss of accommodation.
• Defective vision: High degree hypermetropia and total loss of accommodation cause defective vision for both distance and near.
• Cyanopsia: Absence of lens cause cyanopsia or blue vision. Some individuals have said that they perceive ultraviolet light, invisible to those with a lens, as whitish blue or whitish-violet.
• Erythropsia: Sometimes, objects appear reddish.
• Deep anterior chamber: Since the lens is absent, anterior chamber will be deep.
• Iridodonesis: Iridodonesis is the vibration or agitated motion of the iris with eye movement.
• Purkinje test shows only two images; the reflection from anterior and posterior corneal surfaces.
• Iridectomy mark may be seen in surgical aphakia.
• Astigmatism: With-the-rule astigmatism due to corneal wound healing may occur in surgical aphakia, mainly after intracapsular cataract extraction or extracapsular cataract extraction.

Complications

Main complications of surgical aphakia include:

• Spectacle intolerance: Due to image magnification (up to 30%), optical aberration, prismatic effect and roving ring scotoma, spectacles are not well tolerated by aphakic patients. Due to unequal refractive power between the eyes, wearing spectacles with single-eye aphakia may cause double vision.
• Glaucoma: Secondary angle closure glaucoma may occur due to vitreous prolapse.
• Retinal detachment
• Aphakic bullous keratopathy