<prompt> Typically bilateral inferior lens subluxations of the lens is seen in:Marfans syndromeHomocystinuriaHyperinsulinemiaOcular trauma  <response>: B i.e. Homocystinuria Uniocular diplopia together with finding of shining golden crescent on oblique and dark black crescent line on coaxial illuminationQ both bo edge of subluxated lens suggest a diagnosis of subluxated ectopia lentis. Congenital rubella presents with deafness, cardiac malformation and cataract Q. Other defects include glucoma, salt pepper retinopathy, microcephalus, cerebral palsy, intrauterine growth retardation, hepatosplenomegaly, mental motor retardation. but not ectopia lentis or lens dislocation. Q Ectopia lentis or displacement of lens may be seen in Marfans syndrome bilateral supero-temporalQ, homocystinuria bilateral infero-nasal or infero temporalQ and sulfite oxidase deficiencyQ. Ectopia Lentis Displaced Lens - It refers to displacement of lens from its normal position in patellar fossa. Paial displacement of lens i.e. still remaining in pupillary area is called subluxation whereas, completely dislocated lens rendering the pupil aphakia is ka dislocation luxated. - It is usually a bilateral conditionQ caused by extensive zonular malformation. The lens is displaced in the opposite direction to the weak zonules usually superomediallyQ i.e. mostly upwards and bilateral. - Ectopia lentis may be congenital or acquired. The condition is often hereditary congenitalQ and usually presents in childhood or young adulthood. - The clinical features of subluxated lens include poor vision, uniocular diplopia, glare, myopia, astigmatism, reduced amplitude of accomodation and sudden loss of visionQ. Signs include an obvious lens displacement, however, this may not be visible through an undilated pupil. The lens is small but the edge and zonules are generally invisible until the pupil is dilated. So the pupil should be dilated to assess the extent of displacement and intactness of zonules. Fluctuating anterior chamber depth and vision, iridodinesis iridodonesis i.e. tremulous iris and phacodinesis phacodonesis i.e. tremulous or a visibly mobile lens accentuated by eye movements. The lens may displace completely into anterior chamber or vitreous or become cataractous. Vitreous may herniate forward into anterior chamber. Pupillary block glucoma commonly occurs dt anterior herniated vitreous or subluxated lens. Posterior displacement of lens into vitreous may cause lens induced uveitis. - In Marfans syndrome because of frequently intact zonules, the accomodation in retained. Whereas, in homocystinuria the zonules containing high levels of cysteine, disintigrate so the accomodation is often lost. 