8 - Ant Seg Iris Flashcards
Persistent pupillary membrane
Common
Not visually significant
-if severe consider breaking, patching for amblyopia
If prominent, can adhere to ant lens capsule -> anterior polar cataract
Remnants seen in adults
Iris hypoplasia
Iris stroma underdeveloped
If PPE underdeveloped = transillumination
When both stroma and pigment epi are involved:
- if focal = coloboma
- if diffuse = aniridia
Iris transillumination
Seen in albinism (due to absence of pigment in PPE), Marfan, trauma, surgery, uveitis
Iris coloboma
Due to failure of embryonic fissure closing
Typically inferonasal
Looks like inverted teardrop
Typically also involves lens, CB, choroid, retina, and/or ON
Can be AD, family could have small undetected defects
Aniridia
Always binocular!
Photophobia
Often hereditary; sporadic seen in Wilms tumor
-all sporadic cases have to undergo kidney ultrasound to R/O Wilms, genetic evaluation
Congenital iris ectropion
Ectropion on PPE onto the iris surface
Seen in NF, Prader-Willi syndrome
Dyscoria
Abnormality of pupil shape (esp congenital malformations (coloboma, sectoral hypoplasia))
Corectopia
Displacement of pupil
Common
Polycoria
Multiple iris holes
Axenfeld-Rieger
Common cause of iris stromal hypoplasia
Spectrum of developmental disordrs charac by posterior embyrotoxon with iris strands, iris hypoplasia, and significant chance of glaucoma (50%)
-smooth, cryptless iris surface with high insertion, possible transilllumination
Non-ocular: abnormal teeth, anomalies of pituitary gland region
-different genetic mutations can give this presentation
Iris heterochromia
Seen in congenital Horners, Fuch’s heterochromia
