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    Can You Guess February's Mystery Condition?

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    Make your diagnosis in the comments, and look for the answer in next month’s Blink.

    February 2020 Blink


    Last Month’s Blink

    Posterior Lenticonus: “Fishtail” Appearance

    Written by Jitender Jinagal, MS, Gaurav Gupta, MS, and Jagat Ram, MS, Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India. Photo by Jitender Jinagal, MS.

    January 2020 Blink

    A 17-year-old boy presented with com­plaints of blurred vision in his left eye. Best-corrected visual acuity (BCVA) was 20/20 in the right eye and 20/60 in the left. In both eyes, the slit-lamp exam revealed a conical protrusion of the posterior surface of crystalline lens associated with cataractous changes, giving a “fishtail” appearance (photo); these changes were more prominent in left eye. Scheimpflug imaging confirmed the finding of posterior lenticonus in both eyes. Phacoemulsification was performed, followed by implantation of a posterior chamber IOL in his left eye; his post-op BCVA was 20/20.

    Posterior lenticonus is a cone-shaped pro­trusion of the crystalline lens into the vitreous cavity.1 It can be part of an inherited syndrome, such as Alport or Lowe syndrome, or it can be sporadic, as in this case. There is a genetic defect in the synthesis of type IV collagen,2 which can cause fragility in the basement membrane of the lens capsule.


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