Spontaneous rupture of the lens capsule in a case of Marshall syndrome

Spontaneous lens resorption in a patient with Marshall-Stickler Syndrome and glaucoma

Purpose

The purpose of this case report is to describe the increased fragility of anterior capsule in patients with the rare genetic disease Marshall-Stickler syndrome.

Observations

We describe a 3-year old patient with Marshall-Stickler Syndrome and congenital glaucoma treated with glaucoma drainage implant placement who subsequently developed spontaneous lens resorption in one eye, which was noted incidentally during one follow-up appointment.

Conclusions and Importance

It is hypothesized that the lens material left the eye through the glaucoma drainage implant over time. This process was not associated with elevation of intraocular pressures or inflammation and did not require subsequent surgery to remove any residual lens fragments, which has not been reported before to the best of the authors’ knowledge.

Intraocular pressure change in orbital disease

Intraocular pressure change has been found concurrent with many orbital pathologies, particularly those involving proptosis. The objective of this review is to offer an inclusive classification of orbital disease-related intraocular pressure change, not only for oculoplastics and glaucoma specialists, but also for general ophthalmologists. Various orbital conditions associated with increased intraocular pressure and glaucoma are comprehensively summarized, and pathophysiology, clinical manifestations, and treatment options of these diseases are discussed. Graves disease, arterio-venous shunts, trauma, and orbital neoplasia, and other common conditions are discussed in detail; less frequent syndromes such as orbitocraniofacial deformities, phakomatoses, and mucopolysaccharidoses are included for the sake of comprehensiveness, but discussed less extensively.