Posters

Microspherophakia presenting with angle-closure glaucoma

Poster Details

First Author: R.Jomaa MOROCCO

Co Author(s): A. Ouadfel   Z. Haddar   S. Lakrimi   S. Chariba   A. Maadane   R. Sekhsoukh     

Abstract Details

Purpose:

Microspherophakia is a developmental abnormality in which the lens is small in diameter and spherical. The spherical shape of the lens results in increased refractive power, which causes the eye to be highly myopic. Treatment of these patients is difficult and there is no consensus about the treatment approach, especially in patients presenting with secondary angle-closure glaucoma. The purpose of the case is to report the clinical features and management of glaucoma in microspherophakia.

Setting:

Department of ophthalmology, CHU Oujda, Morocco

Methods:

We report a case with microspherophakia, with no medical history beside high myopia, presenting as bilateral angle-closure glaucoma.

Results:

A 19 year-old-girl presented for acute eye pain. She has no medical history beside high myopia. She was on topical intraocular pressure (IOP) lowering agents. Her IOP was 43 mmHg in both eyes. Lenses were appeared to bulge forward into the pupil. Gonioscopic revealed completely closed angles and no anterior synechia was observed with indentation. The entire lens equator was visualized after pupillary dilation. Ultrasound biomicroscopy showed anteriorly displaced small and spheric crystalline lenses, decreased anterior chamber depth and 360 degree closed angles. we proposed a lensectomy. Her IOP was normal after the surgery.

Conclusions:

Microspherophakia is characterized by an increased antero-posterior diameter and a reduced equatorial diameter of the crystalline lens leading to a spherical configuration. Equator of the lens is visible with full mydriasis. Zonular instability might lead to lens dislocation/ subluxation or secondary angle closure glaucoma. Patients might present with diminution of vision or acute eye pain. Optimal management of glaucoma in microspherophakia is still uncertain. Indications for clear lens extraction in patients with microspherophakia are corneo-lenticular contact, unilateral high myopia, pupillary block and secondary intractable glaucoma. In our case, IOP was successfully controlled following lensectomy without additional medication.

Financial Disclosure:

None