DR. RAKHI P DCRUZ

Abstract

Anterior megalophthalmos usually presents early in life with megalocornea, deep anterior chamber, raised intraocular pressure, glaucomatous optic nerve damage, and iridodonesis/stromal thinning with positive family history. We report atypical features and presentations in 2 patients (4 eyes) of non-familial megalophthalmos. While the first patient, a male, presented at 51 years of age, with megalocornea, cataract, phacodonesis, normal pupillary dilatation/normal iris, and advanced glaucoma, the second patient presented with iridodonesis with stromal thinning, aphakia, and advanced glaucoma. Family history and vitreous index was unusually high >70% in all 4 eyes . Thus atypical features like greater vitreous length, absent iris involvement, and late-onset adult presentation is common in non-familial anterior megalophthalmos. Clinical surprises due to varied phenotypes should be kept in mind in such cases.