Wavefront analysis and Scheimpflug imagery in diagnosis of anterior lenticonus

We present the case of an Alport syndrome patient whose anterior lenticonus was detected by wavefront analysis and Scheimpflug imaging technology. The patient's lenticular abnormalities were too subtle to be detected by the initial slitlamp examination. Normal corneal topography and elevation maps with high total-eye aberrations pointed to internal optics as the source of aberrations, and predominant negative spherical aberrations suggested anterior lenticonus, a diagnosis confirmed by Scheimpflug images that showed central bulging of the anterior lens surface. Following diagnosis, uneventful phacoemulsification and intraocular lens implantation were performed. We recommend wavefront analysis and Scheimpflug imaging technology as effective tools in the detection of lens disorders, especially those that are too subtle to be observed by other examination methods.