Sudden Appearance Of A Large Apparent Foreign Body In An Eye After Blunt Trauma A Case Of Sömmering Ring

To present a case of dislocated Soemmering ring in the pupillary area after trivial trauma

Case presented at outpatient clinic of Alexandria Ophthalmology Hospital and the operation performed under general anaethesia at operating room, Alexandria ophthalmology hospital.

A 65-year-old male working as plumber presented with a sudden appearance of large white foreign body in his left eye after blunt trauma. The patient underwent cataract surgery without IOL implantation 53 years ago for taumatic cataract. Clinical examination showed VA of hand movement, conjunctival hyperemia, mild corneal haze and edema, AC occupied by semilunar shaped solid white foreign body. Pupil was upward peaked by the foreign body and IOP was 32 mm Hg. Retina could not be assessed clinically. Combined A and B-Scan ultrasound of the posterior segment was unremarkable. Surgical extraction under general anesthesia was performed. The foreign material was hard in consistency, white in color, semilunar measuring 7 mm long and 2.5 mm in diameter. The shape of the material was unusual for soemmering ring and was not attached to zonules. Lesion was sent for histo-pathological examination. Microscopic examination revealed a disc of amorphous structureless material of lens cortical fibers with evident edema. On day 7, the wound was clean coapted, visual acuity was counting fingers at 50 centimeters, corneal oedema began to resolve and the IOP was 21 mm Hg.  On day 42, the wound was clean, cornea clear, AC formed, pupil semidilated oval reactive and IOP was 16 mm Hg and sutures were removed. Visual acuity improved to counting fingers at one meter. 

Patients who underwent cataract surgery with old-fashioned techniques have a possibility to develop unusual complications such as Soemmering ring and in those cases high myopia is a risk factor for ring dislocation.