Two weeks after blunt trauma to the eye with a cricket ball, a 25-year-old man notices blurred vision. Slit-lamp examination reveals a rosette-shaped opacity with petal-like feathery lines radiating from the posterior pole of the lens. This appearance is due to:

• A Rupture of the anterior capsule with cortical spill
• B Oedema and fragmentation of lens fibres along the sutures ✓
• C Deposition of haemosiderin within the lens stroma
• D Proliferation of lens epithelial cells across the posterior capsule

Explanation

Concussion decompresses the lens momentarily, separating the lens fibres along the Y-shaped sutures. Fluid seeps into the gaps, producing oedema and fragmentation of fibres that appears as a flower-petal rosette, usually at the posterior pole. Capsular rupture would give a progressive cortical cataract instead, and the rosette may partially resolve or later become a permanent dense opacity.

Reference: Khurana, Comprehensive Ophthalmology, 7th ed.

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Written and medically reviewed by the StethoPrep medical team.