Microspherophakia: A Difficult Diagnosis And Treatment

Ophthalmology department of Habib Thameur hospital, Tunis TUNISIA

Microspherophakia is a rare bilateral condition characterized by zonular laxity leading to the development of a small spherical lens. Glaucoma is a serious complication associated with this disorder. We report the cases of two sibling patients referred to our department for the glaucoma treatment. They both suffer from high myopia. Bilateral ocular examination showed normal sclera and cornea, shallow anterior chamber, and thick lens. Intraocular pressure was elevated despite antiglaucoma medications. Gonioscopy showed a narrow iridocorneal angle. Complete mydriasis revealed the entire equatorial margin of the lenses and fundus examination was normal. Ultrasound biomicroscopy and anterior segment OCT confirmed the diagnosis of bilateral microspherophakia. Surgical management of microspherophakia was discussed and a decision tree for the management of miscrospherophakia and glaucoma was defined.

Early identification of the disease, and appropriate lens and glaucoma management can help us prevent blindness from this disease.