Ten days after extracapsular cataract extraction with retained cortical lens matter in the capsular bag, a patient develops granulomatous anterior uveitis with mutton-fat keratic precipitates centered on residual lens material. Histopathologically, this lens-induced uveitis is characterized by:
- A Dalén-Fuchs nodules between Bruch membrane and retinal pigment epithelium
- B Epithelioid and giant cells surrounding escaped lens protein, with polymorphonuclear cells and eosinophils ✓
- C Noncaseating granulomas confined to the choroid with sparing of the lens
- D Deposition of amyloid within the iris stroma
Correct answer: B. Epithelioid and giant cells surrounding escaped lens protein, with polymorphonuclear cells and eosinophils
Explanation
Phacoanaphylactic (lens antigen) uveitis is an immune response to lens proteins exposed by capsule rupture after surgery or trauma, producing a zonal granulomatous reaction: epithelioid and giant cells encircling lens material, surrounded by neutrophils, plasma cells, and often eosinophils. Dalén-Fuchs nodules are found in sympathetic ophthalmia, where the inflammation targets uveal melanocytes rather than lens protein. Recognizing retained lens fragments guides management, which may require surgical removal of the inciting material.
Reference: Parsons' Diseases of the Eye, 23rd ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.