A 14 Years old boy, he presents to us with history of gradual low vision since 2 years. It is associated with itching, photosensitivity and difficulty in breathing. He denies any eye problem when he was young. He had previous history of hydrocephalus that was treated with VP shunt at age of 4 months. There is no history of bone fracture, deafness, dental abnormality or any significant family history. general examination reveals facial asymmetry, skin elastic and joint hypermobile.

Key words that will help writing introduction
Talk about these three diseases and link them together

1. Megacornea
2. Keratoglobus
3. Heart disease (pulmonary artery stenosis)
(please use the articles that I have attached as a reference) I need you to use 2 of them only, choose what it is good for the introduction. thank you
Nothing to do with the case presentation, it is here just to be familiar with the topic

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case presentation
A 14 Years old boy, he presents to us with history of gradual low vision since 2 years. It is associated with itching, photosensitivity and difficulty in breathing. He denies any eye problem when he was young. He had previous history of hydrocephalus that was treated with VP shunt at age of 4 months. There is no history of bone fracture, deafness, dental abnormality or any significant family history. general examination reveals facial asymmetry, skin elastic and joint hypermobile. on ophthalmic examination, limitation of upward movement OD OU ??, keratoglobus with very thin inferior cornea, megalocornea (corneal diameter OD with caliper 15.5 OS 13.5), Sclera normal OU not blue lens clear and central OU Axial length OU . Anterior chamber quite OU, IOP normal OU. OU lens clear and discs show deep cup (large discs) but heathy rim. No RD IMP: keratoglobus but flatter ks. B scan OU flat with posterior staphyloma. no orbital pathology photo.
cardiac evaluation reveal left pulmonary artery stenosis
Refraction:
Sph cyl axis VA-Dt
OD -2.00 -4.25 20 20/60
OS -2.25 -2.00 170 20/40

Wearing glasses 3 year
Tall high but k/o joint, bone or skin problems

Megalophthalmus ehlar danlos ? suggest get a referral from
His local hospital to a big hospital for cardiac and orthopedic appointment
Protective glasses lubs r 3m

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