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41-year-old woman was seen in the office on 9/3/2010. She was doing fine, as far as she knew, until January of this year when she had difficulty with her vision in the right eye later in the day and it was determined at that time she had a dislocated natural lens in the eye, probably associated with Marfan syndrome. She has been checked. Her heart is okay and now that her vision is worsening, there is concern about what should be done. In addition, she is developing intermittent probable pupillary block in the right eye from the lens, and because of that, there is some urgency with proceeding with the right eye even though the lens is not fully dislocated. VISUAL ACUITY: Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/25. IOP: OD 16, OS 14. SLIT LAMP EXAM: The right eye does have a dislocated natural lens inferiorly and the lens is tilted forward touching the pupil. The lens in the left eye is dislocated nasally. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. IMPRESSION: ECTOPIA LENTIS – BOTH EYES DISCUSSION: I explained to the patient she does have ectopia lentis in both eyes associated with Marfan syndrome. The reasonable procedure would be to remove the lens with a vitrectomy and fragmentation and then to place a lens in the eye. I told her there are several options, including a sutured posterior chamber intraocular lens, an anterior chamber intraocular lens, and an iris clip lens. I will check into these options to see what might be the best course for her. She has nice round pupils and I think the new iris clip lenses might be the best choice. I will probably schedule her case for the next few months. I will contact you as to what would be appropriate lens calculations, and I will have her see you back regularly as well. I warned her there is a risk of retinal detachment with the lens surgery and she will need to be watched closely for that postoperatively.

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Ectopia Lentis - Marfan's Syndrome - Intermittent Pupillary Block Glaucoma Right Eye686 views41-year-old woman decreased vision right eye and intermittent pupillary block glaucoma for 6 months from a dislocated natural lens in the eye, probably associated with Marfan syndrome.Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/2500000
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Ectopia Lentis - Marfan's Syndrome - Intermittent Pupillary Block Glaucoma Right Eye631 views41-year-old woman decreased vision right eye and intermittent pupillary block glaucoma for 6 months from a dislocated natural lens in the eye, probably associated with Marfan syndrome.Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/2555555
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Ectopia Lentis - Marfan's Syndrome - Intermittent Pupillary Block Glaucoma Right Eye643 views41-year-old woman decreased vision right eye and intermittent pupillary block glaucoma for 6 months from a dislocated natural lens in the eye, probably associated with Marfan syndrome.Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/2500000
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Ectopia Lentis - Marfan's Syndrome - Intermittent Pupillary Block Glaucoma Right Eye452 views41-year-old woman decreased vision right eye and intermittent pupillary block glaucoma for 6 months from a dislocated natural lens in the eye, probably associated with Marfan syndrome.Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/2500000
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41-year-old woman was seen in the office on 9/3/2010. She was doing fine, as far as she knew, until January of this year when she had difficulty with her vision in the right eye later in the day and it was determined at that time she had a dislocated natural lens in the eye, probably associated with Marfan syndrome. She has been checked. Her heart is okay and now that her vision is worsening, there is concern about what should be done. In addition, she is developing intermittent probable pupillary block in the right eye from the lens, and because of that, there is some urgency with proceeding with the right eye even though the lens is not fully dislocated. VISUAL ACUITY: Vision OD is 20/160, PH 20/40; OS is 20/30, PH 20/25. IOP: OD 16, OS 14. SLIT LAMP EXAM: The right eye does have a dislocated natural lens inferiorly and the lens is tilted forward touching the pupil. The lens in the left eye is dislocated nasally. EXTENDED OPHTHALMOSCOPY: OD: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. OS: Vertical C/D ratio is 0.1. There is no posterior vitreous separation. The macula and periphery look healthy. IMPRESSION: ECTOPIA LENTIS – BOTH EYES DISCUSSION: I explained to the patient she does have ectopia lentis in both eyes associated with Marfan syndrome. The reasonable procedure would be to remove the lens with a vitrectomy and fragmentation and then to place a lens in the eye. I told her there are several options, including a sutured posterior chamber intraocular lens, an anterior chamber intraocular lens, and an iris clip lens. I will check into these options to see what might be the best course for her. She has nice round pupils and I think the new iris clip lenses might be the best choice. I will probably schedule her case for the next few months. I will contact you as to what would be appropriate lens calculations, and I will have her see you back regularly as well. I warned her there is a risk of retinal detachment with the lens surgery and she will need to be watched closely for that postoperatively.