Aphakia breaks down into the prefix ‘A’ and Latin root ‘Phako,’ where
Prefix A means ‘without’ or ‘lack of,’ and
‘Phako’ translates to the ‘lens’ of the eye.
Thereby Aphakia is an ocular manifestation that translates to “without the lens.” Individuals with aphakia have either one or both lenses missing since birth. It can also manifest in the later half of the life when,
Do you know? Around 6.1 million (5.1%) population in the world either have pseudophakia or aphakia. There is not only a single cause or type, as agents and factors for such may vary. So we begin with the types of aphakia.
This is a rare condition where an individual is born without a lens
Aphakia is the absence of the lens on either or both eyes after one undergoes its surgical removal. It can happen post-cataract or removal of any perforating wound or ulcer via a congenital anomaly.
Optical aphakia is also known as post-dislocation aphakia. In aphakia, this lens is gone. This can happen for several reasons:
This condition can arise from trauma or underlying systemic diseases that weaken the zonules. The fibers that hold the lens in place are not functioning and thereby the lens is absent.
In cases of optical aphakia, lens dislocation can be classified based on its severity and direction:
| Basis | Ectopia Lentis Simplex | Ectopia Lentis et Pupillae |
|---|---|---|
| Inheritance | Passed down in families where only one parent needs to carry the faulty gene. | Passed down in families where both parents must carry the faulty gene. |
| Lens Position | The lens moves to the upper-outer side of the eye in both eyes. | The lens moves in one direction, and the pupil moves in the opposite direction in both eyes |
| Lens Movement | the lens moves on its own | The lens and pupil move in opposite directions like a seesaw. |
| Other Eye Problems | Usually none | Larger-than-normal corneas Smaller-than-normal, oddly shaped lenses |
Aphakia can be genetic, due to pre-natal development issues of the lens in the mother's womb. It can also manifest as the repercussions of cataract surgery. We will discuss what will happen to our eyes, when our eyes lose the natural lens, for a better understanding of the topic.
Marfan syndrome is a genetic disorder that causes dislocation of the lens (optical aphakia). Individuals born under this condition are muted in the fibrillin-1 gene, which causes the lens to shift and move in a superior-temporal direction. Research mentions that 65% of individuals with Marfan syndrome are already experiencing this problem with ectopia lentis (lens dislocation).
This metabolic disorder can also lead to lens subluxation and progressive vision issues. It is associated with similar ocular manifestations as Marfan syndrome but may involve different mechanisms of lens dislocation.
Weill-Marchesani Syndrome is a rare genetic disorder that can cause optical aphakia. It sounds similar to Marfan Syndrome but it is different. Though both impact the connective tissues, this Syndrome especially causes,
These aphakia are most prevalent in Hispanic populations (8.2%), 4.8% in African Descent, and 9.9% in Chinese Americans as the data suggests. It is also known as homozygous nonsense mutations. We might not be aware but children born from marriage between close relatives in consanguineous communities also tend to develop congenital primary aphakia.
The lens no longer separates the aqueous humor from the vitreous humor if there is an aphakia condition diagnosed in an individual. The lens usually contributes +16 D power to the eyes and if there is no or damaged lens, then the dioptric apparatus of the eyes changes.
Image by Insight Ophthalmology
We only have the cornea left with the single refractive surfaces. Thereby handed operation of the eye, so the power of the eye now will be reduced. Thereby,
Not only the above symptoms but when the eye loses its natural lens, there is an increased risk of the eyes. It can suffer from other eye diseases with its progressive aphakia like,
If a person has surgical aphakia, the chances of astigmatism are high. There are two conditions here,
The symptoms are very obvious. Imagine what will happen to your eyes, if you don’t have the lens for refraction of image. The eyes are out of focus and you start to see blurred images, hues, or vision distortions.
Pupil: Jet Black un color
Purkinje image test: Only 2 Purkinje images
Fundus examination: Small Hypermetropic disc
In normal eyes, there are about 4 Purkinje images that come consecutively from the anterior and posterior surface of the cornea and lens. When the entire lens is gone, only 2 Purkinje images are perceived.
Aphakiac obstacles are the most common method of treating aphakia in the past. Today, when the surgery is not done and the patient cannot wear contact lenses, still there is the practice of using those spectacles.
Image magnification in aphakia is a significant concern when correcting vision with spectacles. Aphakic spectacles can magnify images by approximately 30% to 33%. (It is around 1/3rd more magnified) and enhanced performance is seen in the Snellen test.
The Aphakic glasses prescription can vary from patient to patient. In most cases, diplopia may arise.
The design of aphakic lenses can introduce various optical aberrations, such as radial astigmatism, spherical aberration, and chromatic aberration.
Real life becomes much more challenging with spherical aberrations. Even straight lines seem to curve with these, and disturbing illusions like doors appearing curved inwards and narrow spaces to pass by occur.
Aphakic patients can prevent this by always putting their heads straight and looking through the central point.
The Jack-in-the-Box phenomenon and roving ring scotoma are visual disturbances commonly experienced by individuals with aphakia.
Whenever a patient is in the room the area with clear vision will be surrounded by fog and even the objects outside the peripheral vision appear blurry, thereby needing extra period for adjustments.
Roving Ring Scotoma is when objects disappear and then reappear as they cross the edge of the lens. The unpredictable nature of visual distortions can also lead to anxiety.
Aphakic glasses are quite heavy and keep on slipping down the lens. This bulkiness can lead to aesthetic concerns, making patients reluctant to wear them consistently. Even patients wearing aphakic glasses have adaptation issues with the glass at first.
Today we intend to educate people on conditions like aphakia which is often confused with pseudophakia. Watch out for the symptoms and signs in your and your loved one's eyes.
If you have any prevailing issues in your eyes, book conveniently online or offline appointments with our experienced eye care professionals. You can also directly visit our clinics in Makal Bari, Lazimpat, and Boudha (Tushal).
Aphakia and cataracts are two different cases, not to confuse it with childhood cataracts. When cataracts are surgically removed in infants without IOL then the chances of aphakia are seen.
Also, children get affected by cataracts due to the abnormal lens development during pregnancy. Similarly, congenital and developmental cataracts are more viable and found in young infants.
Yes, we provide emergency eye care for conditions like eye injuries, sudden vision loss, and infections. If you experience any urgent eye problems, please contact us immediately, and our team will assist you in getting the care you need.
Signs to watch for include blurry vision, floaters, sudden loss of vision, eye pain, redness, or sensitivity to light. If you experience any of these symptoms, it’s important to schedule an eye exam at Vision Concern Eye Clinic as soon as possible for early diagnosis and treatment.
If you’re experiencing blurred vision, headaches, or eye strain, it may be a sign that you need glasses or contact lenses. Our eye exams will help determine whether you need corrective lenses. We’ll also discuss your options based on your lifestyle and preferences, including glasses, contacts, or even refractive surgery like LASIK.
