|Year : 2021 | Volume
| Issue : 3 | Page : 459
Zonular laxity and pupillary block glaucoma in microspherophakia
Vijayalakshmi A Senthilkumar, Shilpa More
Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai, Tamil Nadu, India
|Date of Web Publication||02-Jul-2021|
Dr. Shilpa More
Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai - 625020, Tamil Nadu
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Senthilkumar VA, More S. Zonular laxity and pupillary block glaucoma in microspherophakia. Indian J Ophthalmol Case Rep 2021;1:459
A 29-year-old woman presented with defective vision in both eyes. Slit-lamp image of the left eye (OS) revealed shallow anterior chamber depth of Van Herricks grading VH1 both centrally and peripherally, anteriorly subluxated small spherical lens with visibility of the entire lens equator [Figure 1]a with lax and broken zonules [Figure 1]b. Best-corrected visual-acuity (BCVA) OS was 6/24 with – 28 Dsphere with intraocular pressure (IOP) of 24 mm Hg and gonioscopically occludable angles. She had a posteriorly dislocated lens in the vitreous in the right eye (OD) with BCVA 1/60 and IOP 32 mm Hg. Fundus examination showed glaucomatous optic atropy in OD and near-total cupping in OS. Our patient had no clinical features characteristic of microspherophakia associated syndromes like Weil Marchesani syndrome, Homocystinuria, Marfan syndrome, Alport syndrome, Klinefelter syndrome, Lowe syndrome, Peter's anomaly, Cri-du-chat syndrome. The patient was diagnosed to have isolated microspherophakia with secondary glaucoma and was started on ocular hypotensive medications. Subsequently, she underwent pars plana lensectomy with scleral-fixated intraocular lens. She was advised to continue antiglaucoma medications. Pathogenesis of microspherophakia is due to defective development of lens zonules and may lead to acute onset pupillary block and secondary angle-closure glaucoma.,
|Figure 1: Slit lamp photograph after dilatation by retroillumination showing a small microspherophakic lens with visibility of the entire lens equator (a) and Magnified image (b) showing the attachment of lax and broken zonules to the lens equator as well as decreased number of zonules as noted by increased space between the zonular fibres|
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The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
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| References|| |
Chan RT, Collin HB. Microspherophakia. Clin Exp Optom 2002;85:294-9.
Willoughby CE, Wishart PK. Lensectomy in the management of glaucoma in spherophakia. J Cataract Refract Surg 2002;28:1061-4.