Alport Syndrome: An Aberrated Lens

A young male patient presented to us with a gradually progressive diminution of vision in both eyes for a decade. The diagnostic dilemma was sorted out by eliciting an oil droplet reflex on direct ophthalmoscopy and a scissoring reflex on refraction, along with a clinically visible subtle conical protrusion of anterior lens curvature on dilated slit lamp examination. Anterior segment OCT and higher-order lenticular aberrations on ITrace supported the evidence of an anterior lenticonus. A systemic workup revealed renal involvement and sensorineural hearing loss which led us to a final diagnosis of Alport syndrome. The patient underwent sequential bilateral femtosecond laser-assisted cataract surgery with a good gain of vision in both eyes.