Can You Guess June's Mystery Condition?
Make your diagnosis in the comments, and look for the answer in next month’s Blink.
Last Month’s Blink
Bilateral Ectopia Lentis in Suspected Marfan Syndrome
Written by Nitin K. Menia, MS, Reema Bansal, MS, and Sandeep Bansal, MS. Photos by Arun Kapil. All are at Advanced Eye Centre, Post Graduate Institute Of Medical Education and Research, Chandigarh, India.
A 13-year-old girl presented for visual assessment. Her BCVA was 20/30 in both eyes. IOP was 16 mm Hg and 14 mm Hg in the right and left eyes, respectively. The anterior segment examination showed superonasal subluxation of the crystalline lens with visible stretched zonules in both eyes (Figs. 1 and 2). Fundus examination was unremarkable.
Systemic evaluation by the pediatrician revealed features suggestive of Marfan syndrome, including a small forehead, low-set ears, long triangular face with malar hypoplasia, microstomia, peaked nose, and high-arched palate with disorganized teeth. She had mild mitral valve and tricuspid valve regurgitation and bilateral conductive hearing loss. Homocystinuria and Weill-Marchesani must also be considered in the differential diagnosis of ectopia lentis in a young person.
Because the patient had VA of 20/30, without anisometropia, significant astigmatism, or complications related to subluxated lenses (such as cataract, glaucoma, uveitis, or retinal detachment), her physicians determined that she did not require immediate treatment. She will receive regular ocular and pediatric follow-up to monitor for progression.
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