A 34-year-old woman presented with photophobia in both eyes. Six months earlier while abroad, the patient had bilateral cosmetic iris implants (BrightOcular) placed. The patient had a mild change in refractive error postoperatively and was offered laser in situ keratomileusis surgery for correction. She did not report any other immediate postoperative complications. For 4 weeks before presentation, she had blurred vision of the right eye.
Her visual acuity was 20/50 OD and 20/25 OS. Intraocular pressure (IOP) was 31 mm Hg in the right eye and 17 mm Hg in the left. The pupillary reflex could not be visualized secondary to the iris implants. Slitlamp examination revealed trace anterior chamber cell bilaterally with pigmented keratic precipitates. The implants were overlying the iris structures (Figure 1A). Results of an ultrasonographic biomicroscopy are shown in Figure 1B. Posterior examination was limited by the iris implants, but the optic nerve did not reveal edema or hemorrhages. The peripheral retina could not be visualized in either eye.