Spontaneous Capsular Rupture Of Both Eyes In A 15-Year-Old Patient

The purpose of this case report is to display the surgical management following spontaneous capsular rupture in a 15-year-old patient. Following a clinical evaluation that included a review of family history and complementary studies, a diagnosis of Alport Syndrome was made. The significance of this case lies in the rarity of this condition, underscoring the importance of documenting and analyzing such situations to improve therapeutic approaches in patients with uncommon diagnoses.

We report a case of a 15-year-old male patient who, presents to the consultation due to blurry vision in the right eye that has been progressing for 20 days and pain that has been progressively worsening over the past 8 hours. In the early morning of the day of the consultation, the patient experienced ocular pain and leukocoria. The patient denies any history of ocular trauma.

Clinical findings: Right eye: Visual acuity: light perception; Biomicroscopy: capsular rupture with lens material occupying the anterior chamber; Intraocular pressure: 48 mmHg; Ultrasound: posterior pole without abnormalities. Left eye: Visual acuity: 20/40; Biomicroscopy: normal anterior segment; Intraocular pressure: 12 mmHg; Fundus: normal.

Management: IV mannitol and acetazolamide were prescribed.Cataract surgery by phacoemulsification was scheduled. Post operative follow up: Right eye visual acuity 20/50. Intraocular pressure: 13 mmHg Nine months later the patients presents to the consultation due to blurry vision in left eye. The patient reports that, over the past month, vision has progressively decreased in the same manner as the problem in the right eye began nine months ago.

Family history was investigated, the patient reports that his mother suffered from renal failure and required a transplant, additionally, his brother is currently on dialysis.

Clinical findings Left eye: Visual acuity: 20/60; Intraocular pressure: 16 mmHg; Rupture of the anterior lens capsule is observed.

Additional exams: Biometry: Normal.Urinalysis: Proteins 75 mg/dl; Hemoglobin 150/UL; Red blood cells 8,7 x field; Microalbuminuria 443,7 mg/dl; Renal Biopsy: splitting of the glomerular basement membrane. Cardiology: Hypertension. Audiometry: Mild hearing loss for speech frequencies in the right ear and moderate loss for speech frequencies in the left ear.

This case underscores the importance of early diagnosis and multidisciplinary management in Alport Syndrome, a genetic disorder with ocular, renal and auditory manifestations. Clinicians should be alert to the ocular features of Alport Syndrome, such as spontaneous anterior lens capsule rupture, a rare but significant complication. Early diagnosis and subsequent genetic testing of affected families are crucial for timely intervention and better prognosis. Managing Alport Syndrome requires interprofessional collaboration among nephrologists, otolaryngologists, and ophthalmologists to address systemic complications and improve patient outcomes.