Anterior lenticonus refers to the anterior conical protrusion of the native lens and is demonstrated in this illustration through cross-section. Anterior lenticonus is observed in patients with Alport Syndrome. Alport Syndrome manifests due to genetic mutations for type IV collagen production. Type IV collagen provides critical architecture for the human ear, eyes and kidneys. Mutated variants can impair kidney function and hearing function(sensorineural). Hematuria is considered the earliest manifestation of this syndrome. Ophthalmic associations include dot-fleck retinopathy, posterior polymorphous corneal dystrophy and anterior lenticonus as illustrated. Alport Syndrome is most commonly commonly x-link inherited but can also have an autosomal dominant and autosomal recessive pattern.