Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Filter by Categories
Book Review
Book Reviews
Classics In Indian Medicine
Clinical Case Report
Clinical Case Reports
Clinical Research Methods
Clinico-pathological Conference
Eminent Indians in Medicine
Everyday Practice
Film Review
History of Medicine
Images In Medicine
Indian Medical Institutions
Letter from Bristol
Letter from Chennai
Letter From Ganiyari
Letter from Glasgow
Letter from London
Letter From Mumbai
Letter From Nepal
Medical Education
Medical Ethics
Medicine and Society
News From Here And There
Notice of Retraction
Original Article
Original Articles
Review Article
Selected Summaries
Selected Summary
Short Report
Short Reports
Speaking for Myself
Speaking for Ourselve
Speaking for Ourselves
View/Download PDF

Translate this page into:

Images In Medicine
doi: 10.4103/0970-258X.291302
PMID: 32769256

Lenticular corona: Aura of the microspherophakic lens

Brijesh Takkar, Sudarshan Khokhar, Anubha Rathi, Nripen Gaur, Esha Agarwal
 Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India

Corresponding Author:
Brijesh Takkar
Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi
Published: 01-Aug-2020
How to cite this article:
Takkar B, Khokhar S, Rathi A, Gaur N, Agarwal E. Lenticular corona: Aura of the microspherophakic lens. Natl Med J India 2019;32:252
Copyright: (C)2019 The National Medical Journal of India

A 10-year-old girl presented with a complaint of frequently changing power of glasses. Her refractive error had increased from –4D to –16D over a period of 6 years. There was documented history of lenticular disorders in her father and 13-year-old brother (both microspherophakia) and her aunt and grandfather (precise diagnosis not documented). She was normal on systemic examination and her best spectacle-corrected distant visual acuity was 6/12 in both eyes. She had centrally placed crystalline spherical lens with intact zonules in both eyes, the lens diameter being <8 mm. These appeared as bilateral golden rings on distant examination of the face after mydriasis [Figure - 1]a. The slit-lamp examination under diffuse light conditions gave the spherical lenses appearance of having a corona [Figure - 1]b, while on examination under retroillumination, the lenses had an appearance of a breaking solar eclipse [Figure - 1]c. Rest of the ocular examination and intraocular pressure were within normal limits. The patient was diagnosed as a case of familial autosomal dominant mircospherophakia (ADM) with lenticular myopia.

Figure 1: (a) Clinical photograph after mydriasis showing a bilateral golden ring sign, suggestive of microspherophakia; (b) slit-lamp diffuse light examination photograph depicting lenticular corona resembling a sparkling solitaire; (c) the lens had an appearance of a breaking solar eclipse on retroillumination during the slit-lamp examination. The zonules are stretched but intact

The causes of microspherophakia include Weill–Marchesani syndrome, Marfan syndrome, ADM, hyperlysinaemia and isolated cases. The cause of the abnormally small and spherical lens is believed to be rudimentary and long abnormally inserted zonules, resulting in a lack of tension on the lens.[1] In this case, the absence of systemic disease and well-documented family history enabled us to diagnose the patient as ADM. The golden ring seen at the edge of the small lens is believed to be due to intense reflection of light.[2] This results in lenticular corona on mydriatic examination, which should be considered pathognomic of spherophakia. We have previously managed cases of spherophakia with subluxated or dislocated lenses with ‘dual support’,[3] but opted to follow-up this patient in view of good corrected visual acuity.

Conflicts of interest. None declared

Nagata M, Takagi S, Yamasaki A, Tsunematsu S, Kumagami T, Itamochi C, et al. Histopathological study of microspherophakia in the weill-marchesani syndrome. Jpn J Ophthalmol 1995;39:89-95.
[Google Scholar]
Nayak B, Sinha G, Patil B, Khokhar S. Golden ring in the eyes: Weill-marchesani syndrome. BMJ Case Rep 2015;2015. pii: bcr2015210547.
[Google Scholar]
Khokhar S, Gupta S, Kumar G, Rowe N. Capsular tension segment in a case of microspherophakia. Cont Lens Anterior Eye 2012;35:230-2.
[Google Scholar]

Fulltext Views

PDF downloads
Show Sections