Adult onset buphthalmos in a patient with marfan syndrome

PURPOSE: To report a Marfan patient with an adult onset of buphthalmos. DESIGN: Observational case report. METHODS: Review of clinical, photographic, and ultrasound data of a 20-year-old Marfan patient who underwent an intraocular lens implantation complicated by late retinal detachment, chronic hyphema, and elevated intraocular pressure (IOP). RESULTS: A 6-month period of IOP between 25 and 30 mm Hg resulted in a 3.75 mm increase in axial length, a 1-mm increase in corneal diameter, and a 2 mm increase in exophthalmos. CONCLUSIONS: Buphthalmos secondary to long-term ocular hypertension can occur in an adult patient with Marfan syndrome presumably because of abnormal collagen structure. Thus, Marfan patients with high IOP should be treated aggressively to avoid optic nerve damage and other anatomic and structural changes.