Dr.Chandni Chakraborty
The most common presenting signs are leukocoria (white papillary reflex due to a dense retro lenticular membrane or cataract,) microphthalmia and cataract, but the clinical presentation may vary. Here we present a case of PHPV, where there was a very small posterior capsular opacity less than 3 mm in diameter which was apparently visually insignificant but caused a significant visual disturbance due to lenticular astigmatism around +2.75 D at 170 degree that could not be corrected beyond 20/100 even with glass.
The patient underwent lens aspiration with primary posterior capsulotomy with augmented anterior vitrectomy and PCIOL implantation. The astigmatism was corrected immediately to + 0.75 at 10 degree after surgery and IOL implantation and BCVA improved to 20/60 with some amount of meridional amblyopia.
Therefore we can conclude that an apparently visually insignificant cataract may produce significant visual disturbance that can be well taken care of by surgical intervention.


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