DR. S R SREELEKSHMI

DR. KAVITHA C. V., DR. PAVANA KRISHNARAJ ACHARYA, DR. SANDEEP K., DR. NARENDRA N

Abstract

Introduction

Microspherophakia is characterized by small spherical crystalline lens with increased AP thickness.Spherical lens leads to pupillary block&secondary ACG.

Case Report

A 10yr old girl presented with sudden painful DOV,redness&lacrimation BE-5 days.No family&syndromic h/o.O/E-mental status normal,BE-BCVA-3/60,wet refraction(-5),IOP-56,conjunctiva-CCC,cornea-edematous,shallow AC- irido-lenticular adhesions,pupils mid dilated fixed,Lens equator seen on full mydriasis.Fundoscopy-edematous disc.BE-CCT-560μm&AS-OCT-anteriorly placed small spherical crystalline lens APthickness-OD-4.21mm&OS-3.76mm&360°angle closed.ACG subsided with antiglaucoma&antibiotic-steroid medication-5days.IOP stabilized& pupillary block relieved.Referred for clear lens extraction &secondary IOL implantation.

Conclusion

Sudden painful DOV in ACG due to Microspherophakia is rare&challenging clinical scenario.Prompt diagnosis,appropriate management&early referral mandatory to prevent permanent visual loss.