Marfan syndrome can affect the eyes in many ways. For this reason, people with Marfan syndrome should see an ophthalmologist (a medical doctor who takes care of the eyes) to find out if they have any eye problems and learn how to care for their eyes.
Except for dislocated lenses, all of the eye problems in Marfan syndrome also occur in the general population. As a result, doctors do not always realize these eye problems are related to Marfan syndrome. It is important to know that even though these problems occur in the general population, they are much more common in people who have Marfan syndrome.
Some features of the Marfan eye can cause problems with seeing clearly (vision problems). These include:
About 6 out of 10 people with Marfan syndrome have dislocated lenses in one or both eyes. This means the lens, located at the front of the eye, has slipped out of place. The lens can slip in any direction—up, down, to the side, or back. It can slip a little or completely out of place, and anywhere in between. Because the lens is out of place, dislocated lenses cause problems with seeing clearly. Babies and children can have dislocated lenses. In most people with Marfan syndrome, dislocated lenses occur before age 20, although lenses can dislocate in someone of any age.
Symptoms of lens dislocation depend on severity (how much the lens has slipped out of place) and may vary from mild to severe nearsightedness, blurred vision, and fluctuating (changing) vision. Early symptoms of a retinal detachment many include:
- New flashing lights
- New floaters
- A gray curtain moving across your field of vision
These symptoms do not always mean a retinal detachment is present, but you should see your eye doctor immediately if any of these signs occur. Lens dislocation can only be confirmed by an ophthalmologist using a special eye test called a slit-lamp eye examination (and the pupil must be fully dilated).
Dislocated lenses are rare in people who do not have a medical condition such as Marfan syndrome. For this reason, people with dislocated lenses should be evaluated for Marfan syndrome if they do not already know why they have dislocated lenses.
Nearsightedness—when objects in the distance are blurred.
Blurred vision caused by an irregular curve of either the lens or the cornea. The cornea is the layer of tissue covering the very front of the eye.
When one eye does not develop normal vision during early childhood. Sometimes called “lazy eye.”
When the eyes point in different directions. Sometimes the eyes turn inward resulting in “crossed eyes,” but the eyes can also turn outward or downward.
When the layers at the back of the eye pull away. A person with a retinal detachment needs to see an eye doctor right away.
A disease of the eye caused by increased pressure inside the eye. Untreated glaucoma can cause blindness.
Clouding of the eye lens before age 60. Cataracts are common in older people who do not have Marfan syndrome, but people with Marfan syndrome can get cataracts at younger ages—even before age 40.
There are some other eye features that often occur in people who have Marfan syndrome. These features do not usually cause vision problems, but they can help doctors decide whether or not a person has Marfan syndrome. They include:
- Flattened curve of the cornea. This feature may make it more difficult to fit contact lenses.
- Larger than normal corneas.
- Difficulty in completely dilating (opening) the pupils when the doctor does an eye exam.
- Obvious sunken eyeballs (enophthalmos)
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