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April 1993

Lisch Nodules in Cushing's Disease

Author Affiliations

Bethesda, Md

Arch Ophthalmol. 1993;111(4):439-440. doi:10.1001/archopht.1993.01090040029018

Lisch nodules are melanocytic hamartomas of the iris, virtually identical to iris nevi in histopathologic examination. They are yellow or brown, welldefined, dome-shaped elevations projecting from the surface of the iris. Their characteristic clinical appearance allows their distinction from common iris nevi with slit-lamp examination. They are not known to result in any ophthalmological complications. Lisch nodules are thought to be specific for neurofibromatosis and constitute the most common ocular feature of neurofibromatosis 1.1 They have been described only incidentally in patients with neurofibromatosis 2 and segmental neurofibromatosis. The prevalence of Lisch nodules in the general population is not well documented. Of 1037 unselected patients in an ophthalmology clinic who underwent slit-lamp examinations, only three without neurofibromatosis were found to have solitary lesions indistinguishable from Lisch nodules.2

Cushing's disease is a rare condition (the incidence is two to five new cases per 1 million individuals per year), representing

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