Medical treatment of crystalline lens dislocation into the anterior chamber in a patient with Marfan syndrome

We report the case of a 32-year-old male with spontaneous crystalline lens dislocation into the anterior chamber with corneal touch and increased intraocular pressure. The case was handled in a conservative way: before bringing the patient to supine position, pharmacological pupil dilation with tropicamide plus phenylephrine was performed. One drop was instilled every 15 min for 1 hour. Once the posterior displacement of the lens behind the iris was confirmed, 2 % pilocarpine was used to reverse pupil dilation. The patient remained on topical 2 % pilocarpine and 5 % sodium chloride solution.