Intraocular lens (IOL) implantation after cataract surgery is routine procedure. Traumatic dislocation of the posterior chamber IOL into the subconjunctival space following blunt ocular trauma is rare and it is considered an ophthalmic emergency. We present a case of a 71-year-old male that presented to our institution with traumatic dislocation of a posterior chamber IOL into the superior-nasal subconjunctival space following blunt trauma to his left eye after an accidental fall on his head. Trauma in a pseduphakic eye can be devastating. Early recognition and treatment of IOL dislocation are of paramount importance to prevent further damage and infections. Half ring sign (Psudophacocele) recognition help in identifying and localizing the dislocated IOL in subconjunctival space. Traumatic dislocation of posterior chamber IOLs have been rarely reported in the literature. Nevertheless, it could happen years after implantation.

Introduction and importance: Uveal effusion syndrome (UES) is a rare condition characterized by fluid accumulation in the suprachoroidal space and is often associated with scleral thickening and impaired transscleral outflow. The management of UES is challenging. We present a case of UES successfully managed with a modified surgical technique involving double scleral flaps with mitomycin-C. Case presentation: A 43-year-old man presented with sudden, painless, decreased vision in his left eye. Clinical examination and imaging revealed bilateral optic disc swelling, choroidal thickening, and inferior exudative retinal detachment in the affected eye. The axial lengths were short, suggestive of nanophthalmos. After an unsuccessful trial of high-dose oral corticosteroids, the patient underwent surgery involving two inferior scleral windows using double scleral flaps, central sclerotomy, and intraoperative application of mitomycin-C. Histopathology revealed a thickened sclera without inflammation. The effusion resolved completely within 6 months postoperatively, with no recurrence over a 2-year follow-up. Discussion: UES remains a surgical challenge, particularly in patients with eyes that have thick sclerae, where conventional drainage is ineffective. The aim of our approach was to reduce scleral resistance to fluid egress while preserving structural integrity. Long-term patency of the scleral windows was likely maintained by the use of mitomycin-C, which helped prevent fibrosis. Compared with previously described techniques, this modification is effective, safe, and structurally conservative. Conclusion: Double scleral flaps combined with mitomycin-C can be an effective surgical option for managing UES. The long-term resolution achieved in this case supports the value of this technique.

Hemangiomas are pathologically considered to be developmental hamartomatous lesions. In the periocular region, capillary hemangioma is commonly encountered in infants and children, and it is of particular importance because of its critical location if involving the eyelid with obstruction of the visual axis. In this chapter, we aim to briefly discuss the pathogenesis and etiology of such lesions, describe the histopathological features, and the diagnostic immunohistochemical stains used, with differentiating features between infantile hemangioma and capillary hemangioma in adults. In the periocular region, the clinical appearance and manifestations depend on three primary locations of the hemangioma: the superficial, subcutaneous, and deep orbital hemangiomas. Treatment options are similar to hemangioma elsewhere, however, as mentioned above, early treatment may be advocated to avoid developing amblyopia (lazy eye) because of visual deprivation or obstruction. The most used therapy in the periocular region is beta-blockers, either orally or locally. Intralesional steroids and sclerosing agents may also be used. Surgical intervention is reserved for deep orbital-selected lesions.