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February 1966


Author Affiliations

Neurological Clinical Research Center Columbia-Presbyterian Medical Center New York 10032

Arch Ophthalmol. 1966;75(2):302. doi:10.1001/archopht.1966.00970050304029

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To the Editor:  1 have read with interest the admirably ably concise review entitled, Dislocated Lenses and Homocystinuria, which appeared in your October issue. This annotation in a distinguished journal of ophthalmology should encourage early diagnosis and referral to appropriate centers for treatment. The numbers of such patients are considerable, as inborn errors of metabolism go. In the three years since the original description, the cases number well over 100.A few points of some practical importance in diagnosis and management require amendment on the basis of newer information. May I supplement this otherwise excellent review?It is quite correct that homocystinuria and Marfan's syndrome are different diseases; however, there may well be difficulty in sorting them out clinically. Older patients with homocystinuria may develop a striking degree of dolichostenomelia and arachnodactyly. In addition, the clinical cardiovascular changes in homocystinuria may render the differential even more difficult. Although it is

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