DR. MITHUN THULASIDAS

DR.AJITA SASIDHARAN

Abstract

Spherophakia patients often present in adolescence or before 50 years of age. A 61‑year‑old woman presented to us with decreased vision in both eyes (BE). Corrected distance visual acuity (CDVA) was 20/200 in right eye (RE) and 20/100 in left eye (LE). Intraocular pressure (IOP) was 40 mmHg in RE and 25 mmHg in LE. Gonioscopy showed appositional angle closure in BE. Undilated fundus examination showed a cup‑disc ratio of 0.4 in BE. Laser peripheral iridotomy (LPI) was performed in BE for relieving the pupillary block. At 1 week follow‑up, IOP was 22 mmHg in RE and 21 mmHg in LE with patent LPI. On dilated examination, the lens showed grade 2 nuclear sclerosis cataract, and was small, spherical, subluxated anteriorly into the pupillary plane, suggestive of spherophakia. The patient underwent phacoemulsification with anterior vitrectomy and retropupillary iris‑claw lens implantation. Postoperatively, CDVA was 20/20 in BE with an IOP of 18 mmHg in RE and 16 mmHg in LE.