Congenital biphakia with double subluxed crystalline lenses
C. Magnetic resonance imaging of the brain and orbits
This is a case of a patient who was referred for evaluation of a likely choroidal mass. However, B-scan ultrasonography and UBM results show that the mass was adjacent to, but separate from, the ciliary body temporally, and the presence of a subluxed lens in the inferior vitreous further complicates the diagnosis.
Because of the uncertainty of the etiology of the mass as to whether it is benign or malignant or even from which tissue it arose, treatment with plaque radiotherapy would not be appropriate. With the patient’s ocular history of amblyopia and poor visual prognosis, there was no visual benefit to removing the subluxed lens. Further imaging of the right eye with magnetic resonance imaging (MRI) was obtained and reaffirmed that the mass was similar in shape and density to the inferior subluxed lens (Figure 2). The MRI, along with autofluorescence, B-scan ultrasonography, and UBM, led us to diagnose congenital biphakia with 2 subluxed lenses1 and we elected observation as opposed to a biopsy.