What is the treatment for a NON-VISUAL anterior lens luxation?

• A. Enucleation
• B. Medical management with topical carbonic anhydrase inhibitors AND no miotics
• C. Trans-corneal reduction 'couching' procedure
• D. Observation

Answer: (A)

When a lens is luxated anteriorly and the eye is no longer able to provide vision, removing the eye is the most definitive and appropriate treatment. An anteriorly dislocated lens in a non-visual eye tends to cause ongoing pain, contributes to corneal edema, raised intraocular pressure, and inflammation, and it poses a risk of sympathetic ophthalmia in the other eye. Enucleation eliminates these problems and spares the patient from a painful, nonfunctional eye.

Medical management or observation does not address the dislocated lens or the pain and inflammatory risks, and cannot restore vision. The couching procedure is an outdated technique with high complication rates and is not used in modern practice.