COMPLEX OCULAR MANIFESTATIONS OF SUSPECTED ALPORT SYNDROME: A CASE OF BILATERAL SECONDARY GLAUCOMA WITH EARLY CATARACT FORMATION

To describe a rare case of bilateral secondary glaucoma associated with suspected Alport syndrome, highlighting the importance of early recognition, surgical planning, and postoperative intraocular pressure (IOP) control in syndromic ocular disease.

Department of Ophthalmology, AKFA Medline University Hospital, Tashkent, Uzbekistan, in collaboration with the School of Medicine, Central Asian University.

A 35-year-old female with suspected Alport syndrome presented with progressive bilateral visual decline, high myopia, anterior lenticonus, and early-stage cataracts. Best-corrected visual acuity was 0.1 in the right eye and hand motion in the left eye. Intraocular pressure was elevated (OD: 30.5 mmHg; OS: 41.0 mmHg), and fundus examination revealed glaucomatous cupping and optic disc pallor in the left eye. OCT confirmed glaucomatous ganglion cell and RNFL thinning, more pronounced in OS. Sequential phacoemulsification with posterior chamber intraocular lens implantation was performed (OD under retrobulbar, OS under topical anesthesia). Postoperatively, the right eye achieved full visual rehabilitation (VA 1.0), while the left eye improved to 0.3. IOP was stabilized with topical brinzolamide/timolol and latanoprost. Long-term follow-up showed stable optic nerve status.

Syndromic features such as anterior lenticonus and high myopia in Alport syndrome should raise suspicion for secondary glaucoma. Early diagnosis, individualized surgical strategy, and strict postoperative IOP control are essential to preserve visual function and prevent irreversible optic nerve damage.