Cholesterol Crystals in the Anterior

THE occurrence of crystals in the anterior chamber of the eye is extremely rare. Parfait-Landrau (1828) first reported the presence of crystals in the living eye. Schmidt (1831) observed a shower of silver and gold dust gush forth when he opened the anterior chamber of an eye blind for years. Blasius (1852) mentioned that 24 cases had been reported, rather a large number considering the rarity of the condition. Lloyd (1928) reviewed the literature and reported a case with a 20-year history of injury, having hypermature cataract and shining crystals suspended in the chamber fluid. Gruber (1955) surveyed the literature for well-authenticated cases of crystals in the anterior chamber, and collected fifteen, to which he added six more (including two patients of Bonaccolto, 1937), a total of 21. Subsequently reports were published by Akiya (1956), Sabbadini and Dugnani (1957), and Georgiades (1957). Forsius (1961) carried out a clinical and chemical study of seven cases and compared his results with a control group of six eyes. His observations did not reveal any appreciable difference in the cholesterol, protein, and total fat values of the aqueous humour and vitreous of the two groups. The albumen content of the anterior chamber and vitreous, however, was on the whole slightly lower in the subjects with cholesterol deposits in the anterior chamber. Forsius did not mention any method, other than microscopy, of identifying the crystals. The following case is the first to be reported from India. It is of additional interest because the crystal deposits were observed in the anterior chamber of a microphthalmic eye, an event not so far recorded in the literature. Following the scheme outlined by Gruber, the nature of the crystals was determined by both microscopic examination and chemical analysis.