If findings in family members are subtle a complete clinical evaluation is recommended because of the degree of variation of the disorder, even in the same family. Family members are also encouraged to speak with a geneticist about their concerns, fears and questions. An MRI is not useful as a routine screening tool, but it is helpful in making a diagnosis if there is back pain. Hip x-rays are often recommended for children with Marfan syndrome before any hip problems become severe. Adults would probably only require a hip x-ray if they already have symptoms in their hips.
Intraocular inflammation is one indication for lens replacement.
The lens should also be replaced if there is retinal detachment behind a lens that is cataractous. Otherwise, someone with the Marfan syndrome who has poor vision should be corrected with refraction, so that the lens can be left in place as long as possible. Viagra should be okay for men with the Marfan syndrome unless they are on the verge of needing aorta replacement surgery or have another cardiovascular problem with symptoms. Leonard Girardi, M.D., New York Hospital-Cornell Medical Center, Paul Sponseller, M.D., Johns Hopkins Hospital, Reed Pyeritz, M.D., Ph.D., Allegheny University of the Health Sciences, Irene Maumanee, M.D., Johns Hopkins Hospital, Cheryll Gasner, M.N., F.N.P., Stanford University Medical Center, Peter Byers, Ph.D., University of Washington, and Barbara Biesecker, M.S., National Human Genome Research Institute.