Heterochromia

Question 1

Describe heterochromia (iridium and irides)

Unilateral/bilateral

Answer 1

• Heterochromia iridum: unilateral, one eye has more than one color
• Heterochormia irides: bilateral, each eye has different colors

Question 2

What are two diseases that hypochromia is associated with?

Answer 2

• Congenital heterochromia

- Horner’s syndrome

Question 3

What five signs associated with hyperchromia?

Answer 3

• Nevus of Ota
• Ocular siderosis (metallic FB causing rust)
• Diffuse nevus or melanoma
• Sturge-Weber syndrome
• Latanoprost (ocular meds)

Question 4

What are two diseases associated with congenital heterochomia irides?

A. Craniodystosis (Crouzon’s disease)
B. Horner’s Syndrome
C. Fuch’s Heterochromic Iridocyclitis
D. Trauma, Surgery, inflammation, foreign body

Answer 4

A. Craniodystosis (Crouzon’s disease)

B. Horner’s Syndrome

Question 5

What are three diseases associated with congenital heterochomia irides?

A. Craniodystosis (Crouzon’s disease)
B. Horner’s Syndrome
C. Fuch’s Heterochromic Iridocyclitis
D. Trauma, Surgery, inflammation, foreign body

Answer 5

B. Horner’s Syndrome
C. Fuch’s Heterochromic Iridocyclitis
D. Trauma, Surgery, inflammation, foreign body

Question 6

Describe Fuch’s Heterochromic iridocyclitis

What kind of uveitis, unliteral?, age onset

Answer 6

• Chronic nongranulomatous anterior uveitis in lighter colored eye
• untilateral, 20-60 years

Question 7

What are signs and treatment of Fuch’s heterochromic iridocyclitis?

(What will you see in the vitreous?)

Answer 7

• Symptoms: floaters from vitreous inflammation or decreased vision from secondary cataracts
• low grade inflammation does not require treatment
• moderal inflammation requires short dose of topical corticosteriod therapy
• High-dose topical corticoid steroids is not helpful

Question 8

What are three signs to look for in Fuch’s Heterochromic iridocyclitis?

(See on iris and lens, blood supply, crypts, what disease could be secondary to this?)

Answer 8

• Iritis, Heterochromia, Cataracts
• keratic precipitates
• iris stromal atrophy, loss of crypts
• prominent radial blood supply
• rubeosis, mydriasis
• iris look more blue
• secondary glaucoma

Question 9

Describe keratic precipatates?

What is it, which structure does it come from, where does it adhere?

Answer 9

• inflammatory cells and WBC
• from iris and ciliary body
• enter aqueous and adhere to cornea

Question 10

What is the difference between keratic precipitates large clusters and punctate:

Answer 10

• Large Clusters: granuloamatous, “mutton fat”
• KP punctate: “non-granulatomatous”, inferior or diffuse
• New: white, smooth, rounded
• Old: shrunken, pigmented or glassy

Question 11

What are five signs of Horners?

Answer 11

• ptosis
• elevation of lower lid
• miosis
• heterochromia
• anhydrosis

Question 12

Describe Persistent pupillary membrane

Is it congenital?, appearance, benign/malignant, effect on age

Answer 12

• Congenital
• Wispy, spiderweb appearance
• benign, may fade with age
• no effect on VA

Question 13

Describe Rubeosis Irides

What pathology causes it

Answer 13

• neovascularization of iris due to retinal ischemia. (Diabetic retinopathy, central retinal vein occlusion)
• Scarring and contraction of abnormal vessels (acquired ectropian uvea)