Isolated Bilateral Ectopic Microspherophakia

Hemalatha Chandrakanthan

Purpose: To present a case of Isolated Bilateral Ectopic Microspherophakia, a rare condition and to identify early detection of any possible complications

Method: Case Report
A 52 year old Malay lady who was a known case of thyrotoxicosis presented with poor vision of both her eyes for a duration of 5 years. She was of normal stature and had no skeletal abnormality. Her visual acuity on both her eyes were 6/60.On slit lamp examination, both eyes revealed clear corneas. Both her lenses were reduced in diameter, spherical, cataractous and dislocated anteriorly occupying the visual axis and with vitreous in pupillary margin. However no lenticular-corneal touch noted. Fundus could not be viewed as she had poorly dilating pupils. Her intraocular pressure was 12mmHg in both eyes. General assessment was performed with an emphasis on cardiovascular and skeletal systems to look for associated systemic disorders and no pathology was identified. Her siblings and children had a ophthalmological examination and were normal.

Results: Based on these findings, a diagnosis of isolated bilateral ectopic microspherophakia was made. She is currently being planned for a intracapsular cataract extraction with anterior vitrectomy and anterior chamber intraocular lens implantation.

Conclusion: Microspherophakia and ectopia lentis are rare conditions and usually associated with multiple malformation syndromes. However in some cases it occurs in isolation and it is important to identify this condition as it is associated with many complications such as secondary glaucoma and corneal decompensation.