Which of the following are clinical signs of lens subluxation?

• A. Mild pain, dyscoria, variable chamber depth
• B. Severe ocular redness with corneal edema
• C. Sudden blindness with no anterior chamber changes
• D. Normal vision with stable chamber depth

Answer: (A)

Lens subluxation occurs when the zonular fibers holding the crystalline lens weaken or rupture, allowing the lens to tilt or shift partially within the eye. This instability often leads to mild eye discomfort as the moving lens and iris interact at the angle and within the anterior chamber. A key sign is dyscoria, an irregular or distorted pupil shape that results from the edge of the subluxated lens pressing on the iris and changing the contour of the pupil. The position of the lens can also cause the depth of the anterior chamber to vary with head or gaze changes, producing a fluctuating chamber depth. Together, these signs reflect an unstable lens rather than a completely dislocated lens or other eye problems. By contrast, severe redness with corneal edema points to corneal or inflammatory/edematous problems, sudden blindness without anterior chamber changes suggests retinal or optic issues, and normal vision with a stable chamber depth would not indicate lens instability.