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Photo Essay
October 1998

Iris Crystals in Fuchs' Heterochromic Iridocyclitis

Arch Ophthalmol. 1998;116(10):1394. doi:10.1001/archopht.116.10.1394

IRIS CRYSTALS are a rare biomicroscopic finding in eyes with chronic iridocyclitis. We report a case of Fuchs' heterochromic iridocyclitis with this peculiar finding.

A 55-year-old woman was examined due to a loss of vision in her left eye. She had chronic, idiopathic iridocyclitis in that eye for the past 6 years. She had been treated by her local ophthalmologist with intermittent courses of topical corticosteroids. Her visual acuity was 20/20 OD and 20/60 OS, improving to 20/25 OS with a pinhole. Intraocular pressure was 16 mm Hg OU. The left cornea showed diffuse, stellate endothelial keratic precipitates over most of its area. There was a cell (2+) and flare (2+) in the anterior chamber. The iris of the left eye was slightly lighter in color than the iris of the right eye. The pupil was round and reactive, with a single inflammatory pupillary nodule, but no synechial formation. Several minute refractile crystals were noted on the anterior surface of the iris, each seen best with side illumination set at a different angle (Figure). A moderately dense posterior subcapsular cataract was found. The anterior vitreous had a cellular reaction (+2) and the fundus was normal. Findings from a routine laboratory workup for anterior uveitis were negative, and the condition was diagnosed as Fuchs' heterochromic iridocyclitis. We therefore discontinued the corticosteroid treatment. The symptoms, as well as the clinical findings, remained unchanged for the next 5 months. The patient decided to postpone cataract surgery.

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