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!
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.