ICD-10: H27.03

Aphakia, bilateral, classified under ICD-10 code H27.03, refers to the absence of the lens in both eyes. This condition can arise from various causes, including surgical removal of the lens (such as cataract surgery), trauma, or congenital factors. Here’s a detailed overview of the clinical presentation, signs, symptoms, and patient characteristics associated with bilateral aphakia:

Clinical Presentation

• Visual Impairment: Patients typically experience significant visual impairment due to the absence of the lens, which is crucial for focusing light onto the retina.
• Refractive Errors: Individuals may present with high degrees of myopia (nearsightedness) or hyperopia (farsightedness) since the lens plays a vital role in refractive power.

Signs

• Pupil Reaction: The pupils may react normally to light, but the overall visual acuity will be markedly reduced.
• Ocular Examination: During an eye examination, the absence of the lens can be confirmed through slit-lamp examination or direct observation.

Symptoms

• Blurred Vision: Patients often report persistent blurred vision, which can be more pronounced at varying distances.
• Glare and Halos: Increased sensitivity to light, glare, and the perception of halos around lights are common complaints.
• Difficulty with Depth Perception: The lack of a lens can impair depth perception, making tasks such as driving or navigating stairs challenging.

Patient Characteristics

• Age: Bilateral aphakia is more commonly seen in older adults, particularly those who have undergone cataract surgery. However, it can also occur in younger individuals due to congenital conditions or trauma.
• Medical History: A history of cataract surgery, trauma to the eye, or congenital eye disorders is often present in patients with bilateral aphakia.
• Coexisting Conditions: Patients may have other ocular conditions, such as glaucoma or diabetic retinopathy, which can complicate their visual status.

Management Considerations

• Corrective Lenses: Patients typically require strong corrective lenses or contact lenses to improve visual acuity.
• Surgical Options: In some cases, intraocular lens (IOL) implantation may be considered to restore focusing ability.

Understanding these aspects of bilateral aphakia is crucial for effective diagnosis and management, ensuring that patients receive appropriate care tailored to their specific needs.