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OPHTHALMIC IMAGE
Year : 2021  |  Volume : 1  |  Issue : 3  |  Page : 459

Zonular laxity and pupillary block glaucoma in microspherophakia


Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai, Tamil Nadu, India

Date of Web Publication02-Jul-2021

Correspondence Address:
Dr. Shilpa More
Department of Glaucoma, Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Anna Nagar, Madurai - 625020, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_3066_20

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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

How to cite this URL:
Senthilkumar VA, More S. Zonular laxity and pupillary block glaucoma in microspherophakia. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 26];1:459. Available from: https://www.ijoreports.in/text.asp?2021/1/3/459/320101



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.[1],[2]
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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Declaration of patient consent

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.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Chan RT, Collin HB. Microspherophakia. Clin Exp Optom 2002;85:294-9.  Back to cited text no. 1
    
2.
Willoughby CE, Wishart PK. Lensectomy in the management of glaucoma in spherophakia. J Cataract Refract Surg 2002;28:1061-4.  Back to cited text no. 2
    


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