Case 18: Iris Lesions

Question 1

Primary iris cyst

Answer 1

Usually peripheral & originate from the iris pigmented epi (MC) or iris stroma

Question 2

Classical presentation of primary iris cyst

Answer 2

Globular, dark-brown lesion that transilluminates. Typically do not grow in size & do not cause sx

Question 3

Secondary iris cyst

Answer 3

Occur after trauma, surgery, or from strong miotic mediations. Result of ingrowth of the surface iris epi

Question 4

Lisch nodules

Answer 4

Small, round, lightly pigmented hamartomas that develop 20s-30s, bilateral, located inf half of iris

Question 5

Lisch nodules are present in 95% of cases of ________

Answer 5

Neurofibromatosis

Question 6

Koeppe nodules

Answer 6

Small, lightly colored iris nodules that are composed of inflammatory cells and are located on the pupillary border of the iris. Assoc w/ granulomatous uveitis

Question 7

Juvenile xanthogranulomas

Answer 7

Benign, usually asymptomatic, yellow-orange nodules composed of vascularized & differentiated lipid-containing histocytes

Question 8

Regarding juvenile xanthogranulomas, approx ___% of cases occur at birth, & ___% of cases develop w/i first year of life; only ___% of cases manifest in adulthood

Answer 8

35, 70, 10

Question 9

Most cases of JXG resolve spontaneously by the age of ___ thus do not require tx

Answer 9

5

Question 10

What is the most concerning threat to vision associated w/ iris cysts?

Answer 10

Iris cysts are often located in the periphery, may cause angle closure & secondary glaucoma due to elevated IOP

Question 11

______ should be performed in pts w/ iris cysts to rule out angle involvement

Answer 11

Gonio

Question 12

Iris metastatic lesions are assoc w/ what 5 complications?

Answer 12

Pseudohypopyon, anterior uveitis, hyphema, iris rubeosis, secondary glauc due to elevated IOP

Question 13

Omega-6 fatty acids are ________ & omega-3 fatty acids are _________

Answer 13

Pro-inflammatory, anti-inflammatory