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Purpose Successful recuperation of vision of a blind eye (cataract?) after forceful rubbing of the eye (producing luxation of the lens?) has been mentioned in the Holy Bible in the 1rst Century (C.). Methods In the 18th C. (1789) the aspiration of cataract was considered. In the 19th C. extracapsular cataract removal was practised but the formation of secondary cataract could not be prevented. In 1917 Prof. Ignacio Barraquer developed a suction cup to remove the cataract ‘in toto’, only possible in case of mature cataract and weak zonule. In 1958 Joaquin Barraquer started to inject alphachymotrypsin into the posterior chamber for enzymatic zonulolysis permitting removal of the lens after 2 min. High optical correction was imperative. Results Ridley recommended extracapsular extraction and introduction of a +20 D lens between the posterior capsule and the iris. Lens luxation into the vitreous cavity or the anterior chamber was a danger. Strampelli suggested a three-point anterior chamber lens but contact with the endothelium increased the danger of corneal decompensation. Binkhorst suggested iris fixation. Conclusions At present, placement of the lens in the capsule, centered with the pupil, is preferred, permitting good near and distance vision without glasses.

A family from Turkey with congenital ectopia lentis, likely occurring as an autosomal recessive trait, is presented. No systemic disorders such as homocysteinuria, Marfan's or Weill-Marchesani's syndromes were found in any of the patients. However, all patients except one were less than 2 years old when first examined so that lens luxation must have happened very early in life. Besides almost total lack of zonular threads the patients presented anomalies of ocular dimensions with increased corneal diameters and axial lengths, and in several cases glaucomatous distension of the optic discs could also be found. A possible explanation for these buphthalmic changes and their relation to lens luxation taking place very early in life is proposed. The importance of early diagnosis and treatment is discussed.

Four cases of homocystinuria with lens luxation have been examined. As judged from the plasma amino acid pattern, they all responded well on pyridoxine treatment. Two of them discontinued the treatment on their own, and one of these died at the age of 17 years. The lens luxation progressed in one case despite adequate treatment. Scanning electron microscopy of one lens revealed partly broken zonules, abnormal zonular attachment, and a spongy appearance of the capsule proper. Hoping that adequate treatment will reduce more serious complications such as thromboembolism in these patients, it is concluded that an early diagnosis largely depends on the ophthalmologist, who should perform the silver-nitroprusside test, specific for homocystinuria, in all patients with non traumatic lens luxation.