SummarySpontaneous absorption of lenses or cataracts is rare. We report a case of bilateral spontaneous lens absorption in a 36-year-old woman for which no cause could be determined despite extensive laboratory testing.
Case ReportA 36-year-old female presented at the eye clinic of Queen Elizabeth Hospital, Kota Kinabalu, Malaysia, with a complaint of poor vision in both eyes since childhood. She had not previously seen an ophthalmologist and had no history suggestive of trauma, surgery, red eyes, or pain. No systemic illnesses were reported. She was born at home; no additional birth history was available. Family and social histories were noncontributory.On examination, visual acuity was hand movements in both eyes. Intraocular pressures were 14 mm Hg in the right eye and 17 mm Hg in the left. The eyes were orthophoric, with full extraocular motility. Slit-lamp biomicroscopic examination was remarkable for whitish membranous structures in the anterior chambers of both eyes that appeared to be empty capsular bags located in the lower part of the anterior chambers (Figures 1, 2A, 3A). No residual zonules or signs of inflammation were evident. The pupils were 3-4 mm and reacted to light sluggishly. Both eyes were aphakic; an intact anterior vitreous face was present. The optic discs of both eyes were hypoplastic and pale ( Figures 2B, 3B, 4, 5).The patient was sent for refractive correction, but her vision failed to improve beyond hand movements in both eyes. Her refraction was +10.00 +3.50 × 55 in the right eye and +11.00 +2.50 × 108 in the left. Routine blood tests, including full blood count, fasting blood sugar, erythrocyte sedimentation rate, blood urea, and serum electrolytes and creatinine, were normal. Testing for congenital infections, including toxoplasmosis, rubella, cytomegalovirus, leptospirosis, and herpes simplex virus were also performed and found to be negative. Computed tomography of the brain and orbits with contrast agents revealed no abnormalities.