Weill-Marchesani Syndrome is one such condition. It is a connective tissue disorder that can be either Autosomal recessive or Autosomal dominant, but the two types can not be differentiated simply by the clinical symptoms. The most common findings include microspherophakia ( small natural lens of the eye), myopia as a result of the abnormal lens shape, ectopia lentis which is an abnormal lens position usually farther forward in the eye closer to the iris, and glaucoma which is the result of a narrow angle because the lens is pushing up against the iris. In addition, lose and broken zonules which hold the lens in place often cause the lens to fall down or backward into the vitreous. The physical stature of these folks is often short and frequently over heavy.

Molecular genetic testing will confirm the diagnosis and type, but the clinical symptoms should help the treating doctor make a preliminary diagnosis and begin therapy.

Treatment of these patients depends on the clinical findings. When the natural lens becomes ectopic it must be removed to decrease the likelihood of pupillary block and secondary glaucoma. In addition, peripheral iridectomies should also be preformed as well as trabeculectomies to prevent future angle closures. These procedures are extremely important because of a paradoxical response to miotics and mydriatics.

Systemic findings often include stiff joints, poor dental alignment and maxillary hypoplasia. These conditions may complicate air passage during anesthesia.

These patients do well when properly diagnosed and treated as well as being closely monitored periodically. Special design contact lenses are often employed to maximize their visual acuity due to large refractive differences between the eyes.

Allergies are caused by chemicals called antigens that create a physiological reaction resulting in symptoms. These are usually ocular redness, tearing and most often itchiness. The best way to decrease allergic reactions is to avoid the antigen. Environmentally, this becomes quite difficult unless one stays in side all the time with the air conditioner on. The other alternative is the reduce the offending agent, interfere with the physiological reaction and treat the symptoms.

Soft contact lenses absorb matter and act as a reservoir for the antigens, slowly releasing them into the eye. Therefore, the type of lens and cleaning methods play a major role in step number one. In very bad allergies, daily disposable contact lenses work well since they are replaced with out any secondary contact with the eye.The other alternative is to wear a very good quality lens that sheds there deposits. Gas permeable lenses work the best in this regard.

Cleaning the lenses is part two. Since allergies trigger certain reactions, and most people with an allergy to one thing will frequently be allergic to other things as well, the best solution for cleaning lenses in allergic folks is a hydrogen peroxide system. Solutions such as AOSept, Oxysept and clear care are the most commonly used for this purpose.

Treatment pharmacologically is the third and most physically rewarding of these steps. In bad allergies, the first step is often with a mild topical steroid eye drop. These can be used for several days to 1-2 weeks depending on the severity of the case. This will bring relief to the patient while reducing or eliminating contact lens wear concomitally. The next step is to begin a long term therapy to maintain comfort and reduce the allergixc symptoms. This is best done with a drop like Patanol or Pataday. These drups reduce the symptoms while blocking the chemical reaction. These drops can be used for prolonged periods of time.

In short, when allergies strike, stop contact lens wear and see your eye doctor as soon as possible. Enjoy your summer!!

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