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Case report
Phakic intraocular lens implantation in a case of Tourette syndrome exacerbated by wearing glasses and contact lenses
  1. Radhika Rampat1,
  2. Vilomi Bhatia2,
  3. Monica Quadir3 and
  4. Romesh Angunawela1
  1. 1Cornea and External Diseases Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2St George's Hospital Medical School, London, UK
  3. 3Consultant Child and Adolescent Psychiatrist, Hillingdon Hospitals NHS Foundation Trust, London, Greater London, UK
  1. Correspondence to Romesh Angunawela; info{at}oclvision.com

Abstract

A 25-year-old longsighted woman presented with a history of spectacle and contact lens induced exacerbation of Tourette syndrome symptoms. Preoperatively, she had very poor unaided vision (6/60), achieving good (6/9) vision in both eyes with spectacle correction. The patient underwent bilateral simultaneous implantation of phakic implantable collamer lens (ICL) implants (STAAR, USA) which sit in front of the natural lens. Postoperatively, her uncorrected visual acuity was markedly improved as were her manifestations of Tourette syndrome. She achieved her full potential of unaided vision (6/9). This is the first documented case of Tourette syndrome triggered by glasses and contact lenses in which bilateral phakic toric lens implants were effective in improving vision and controlling motor symptoms. Phakic toric ICL implantation is a reversible technique for the correction of visually significant ametropia in selected patients and has improved this patient’s quality of life.

  • ophthalmology
  • psychiatry
  • child and adolescent psychiatry

https://doi.org/10.1136/bcr-2020-239799

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    Footnotes

    • Contributors RR: Involved in the direct clinical care of the patient including surgery, writing and editing of manuscript. VB: Involved in planning and editing article. MQ: Expertise regarding patients psychiatric history and its impact as well as critical revision of manuscript. RA: Lead consultant who was in charge of the overall surgical and medical management of the patient and involved in reporting and critical revision of manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.