DR. DIVYA J

DR. PARTHA BISWAS, DR.RICHA KAMAL

Abstract

A 21 year old man presented with gradual, progressive diminution of vision in both eyes for two years. On examination, his best visual acuity was 6/36 and 6/18 in the right and left eyes, respectively. Retinoscopy revealed irregular astigmatism. On slit-lamp biomicroscopy, anterior lenticonus with anterior polar cataract was seen in both eyes. Distant direct ophthalmoscopy revealed oil-droplet reflex.

Patient reported loss of hearing. Audiometry showed bilateral sensorineural hearing loss and urine microscopy revealed microscopic haematuria. Alport syndrome was diagnosed and the patient underwent Femtosecond laser assisted cataract surgery (FLACS) with intra-ocular lens implantation. Post-operative visual acuity in both eyes was 6/6.

Anterior lenticonus is a well-reported feature of Alport syndrome. Capsulorrhexis is particularly challenging in these eyes due to the weakness and elasticity of the capsule. In these eyes, the predictability that FLACS provides is of great advantage.