Marfan's Syndrome: Dislocated Lens
You are looking through a pupil dilated by eyedrops and seeing the . The lens has become dislocated superomedially.
Lens dislocation is common in Marfan's, affecting 50% to 80% of patients. The dislocation is usually superior. Besides causing large refractive errors (for which the patient might need corrective spectacles), it can precipitate glaucoma.
In non-Marfan's patients, the commonest cause of lens dislocation is trauma. Another metabolic disorder to consider is homocystinuria, in which the lens usually falls inferiorly!
Lenticular zonules
In the pupilary space, you see faint . These are the zonules, which suspend the lens from the ciliary muscle like a hammock. Zonules are not visible unless the pupil is very widely dilated by eyedrops.
Other ophthalmic complications
Retinal detachment is also common in Marfan's patients.
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