Cart wheel deposits on the intraocular lens surface

Intraocular lens (IOL) calcification is a rare but recognized postoperative complication, particularly affecting hydrophilic IOLs. We report a case of a 19-year-old male with a history of juvenile idiopathic arthritis (JIA) and chronic anterior uveitis who presented with distinctive cartwheel-like opacities on the anterior IOL surface. Nd:YAG capsulotomy was attempted but did not improve optical clarity. Given the preserved visual acuity (20/40) and stable intraocular inflammation, conservative management with close observation was pursued rather than IOL exchange. This case illustrates secondary calcification as the likely mechanism, attributable to chronic ocular inflammation, and emphasizes the challenges in management where intervention may exacerbate uveitic sequelae.