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Scroll Sign in a Man Aged 50 Years After a Closed Globe Injury

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A 50-year-old otherwise healthy man with no visual complaints presented for a complete ophthalmologic examination. He had a history of closed globe injury in the right eye 6 months prior. On examination, uncorrected visual acuity was 3/60 OD (best corrected, 6/9) and 6/9 OS. Closer examination of his right eye revealed lens capsular rupture and posterior dislocation of the lens (Figure, A). The free edge of the posterior capsule was free and flimsy, and the anterior capsule was rolled over its anterior self (Figure, B), resembling a parchment paper–like scroll. The scroll was also visible on anterior-segment optical coherence tomography (Figure, C). The selective scrolling of only the anterior capsule in this patient was associated with absence of any hyaloid attachment, potentially similar to the selective rolling of the posterior flap of a giant retinal tear in the absence of vitreous adhesion and support.1 These findings suggest that absence of the scroll sign on the posterior capsule may warrant anterior vitrectomy with peripheral iridectomy before an anterior chamber intraocular lens is implanted to prevent pupillary block. In this patient, anterior vitrectomy was performed, and an anterior-chamber intraocular lens was implanted. At the follow-up visit 4 months after surgery and suture removal, his uncorrected visual acuity was 6/18 OD (best corrected, 6/9).

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Amber Amar Bhayana, MD, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar East, New Delhi, India 110029 (amber.amar.bhayana@gmail.com).

Conflict of Interest Disclosures: None reported.

Additional Contributions: We thank the patient for granting permission to publish this information.

Reference
1.
Shunmugam  M , Ang  GS , Lois  N .  Giant retinal tears.   Surv Ophthalmol. 2014;59(2):192-216. doi:10.1016/j.survophthal.2013.03.006PubMedGoogle ScholarCrossref
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