DISEASES OF IRIS.pptx

Uveal tissue is the middle vascular coat of the eyeball.
From anterior to posterior, it can be divided into 3 parts –
IRIS, CILIARY BODY CHOROID.
Iris is the anterior most part of the uveal tract.
The iris consists of four layers,
Anterior limiting layer
Iris stroma
Anterior epithelial layer
Posterior epithelial layer
The colour of iris depends on Anterior limiting layer.

1. Diseases of iris MS. MEGHNA VERMA ASSISSTANT PROFESSOR DEPT OF OPTOMETRY RAMA UNIVERSITY

2. contents DISEASE OF IRIS – Congenital Anomalies Inflammations [Anterior uveitis] Types Of Iridocyclitis Degeneration of iris Cyst and tumours of iris

3. HETEROCHROMIA IRIDIUM Color of one iris differs from the other

4. Congenital anomalies HETEROCHROMIA OF IRIS Heterochromia  is a variation in  coloration  most often used to describe color differences of the  iris, but can also be applied to color variation of hair [1]  or skin. In heterochromia iridium , color of one iris differs from the other. In heterochromia iridis , one sector of the iris may differ from the remainder of iris .

5. HETEROCHROMIA IRIDIS One sector of the iris may differ from the remaining part of iris .

6. CORECTOPIA It refers to abnormally eccentric placed pupil. Normally pupil is placed slightly nasal to the center.

7. POLYCORIA Polycoria  is a pathological condition of the eye characterized by more than one  pupillary opening in the iris. [1]

8. CONGENITAL ANIRIDIA It refers to congenital absence of iris.

9. CONGENITAL COLOBOMA Congenital coloboma (absence of tissue) of iris, ciliary body and choroid.

10. ANTERIOR UVEITIS

11. It is inflammation of the uveal tissue from iris up to pars plicata of ciliary body. It may be subdivided into : Iritis, inflammation of iris . Irido-cyctitis , inflammation of iris and pars plicata part of ciliary body are equally involved. Cyclitis , inflammation of pars plicata part of ciliary body.

12. SYMPTOMS Pain, redness, photophobia, lacrimation, defective vision, blepharospasm . SIGNS Lid oedema - usually mild and severe attack of acute anterior uveitis . Circumcorneal congestion is marked in acute iridocyclitis .

13. Corneal signs - corneal oedema, KPs and posterior corneal opacities. Keratic precipitates (KPs) are proteinaceous cellular deposits occurring at the back of cornea. Mostly, these are arranged in a triangular pattern occupying the center and inferior part of cornea.

14. Anterior chamber signs – Aqueous flare, due to leakage of protein particles into the aqueous humour from damaged blood vessels. Hypopyon - sterile pus is settled down in the anterior chamber. Hyphaem a - blood in the anterior chamber. Changes in depth and shape of anterior chamber - may occur due to synechiae formation .

15. HYPOPYON HYPHAEMA

16. Iris signs - Loss of normal pattern - occurs due to oedema . Changes in iris colour due to hyperpigmentation and depigmentation . Posterior synechiae - adhesions b/w posterior surface of iris & anterior part of lens. Pupillary signs – Narrow pupil - due to irritation of sphincter pupillae by toxins. Irregular pupil shape - results from segmental posterior synechiae formation. [festooned pupil] Pupillary reaction becomes sluggish or absent due to oedema and hyperaemia of iris.

17. Changes in the lens - Exudates may be deposited on the lens acute iridocyclitis . Complicated cataract may develop as a complication of iridocyclitis . Change in the vitreous - Anterior vitreous may show exudates and inflammatory cells after an attack of iridocyclitis . COMPLICATIONS Complicated cataract, secondary glaucoma, choroiditis , retinal complications, macular oedema, retinal detachment and Papillitis . INVESTIGATIONS TLC, DLC, ESR, blood sugar level, serological test, urine examination, stool examination, radiological examination and skin test.

18. TREATMENT OF IRIDOCYCLITIS 1. Non-specific treatment Local therapy Mydriatic-cycloplegic drugs, corticosteroids and antibiotic eyedrops. Systemic therapy Corticosteroids, NSAIDS, immunosuppressive drugs, Physical measures Hot fomentation, dark goggles 2. Specific treatment of the cause 3. Treatment of the complications

19. DEGENERATION OF IRIS

20. SIMPLE IRIS ATROPHY Depigmentation with thinning of iris stroma . It may be senile, post-inflammatory or neurogenic .

21. ESSENTIAL IRIS ATROPHY Very rare. Iris tissue melts away at many places i.e. pseudo- polycoria . Due to formation of dense anterior peripheral synechiae .

22. IRIDOSCHISIS Rare bilateral atrophy with senile degeneration over 65 years of age. Formation of a cleft between the anterior and posterior stroma of the iris.

23. TUMOURS OF IRIS

24. Naevus Most common lesion of iris. Flat, pigmented, circumscribed lesion of variable size.

25. Naevoxantho endothelioma It presents as a single or multiple rapidly growing vascular nodules. It spreads in the angle producing secondary glaucoma. It may penetrate through limbus and present as epi -bulbar mass.

26. REFERENCES Kumar P (2017).  "Focal Scalp Hair Heterochromia in an Infant" .  Sultan Qaboos University Medical Journal .  17  (1): e116–118.  doi : 10.18295/squmj.2016.17.01.022 .  PMC   5380409 .  PMID   28417041 Cassin, B. and Solomon, S.  Dictionary of Eye Terminology . Gainesville, Florida: Triad Publishing Company, 1990 .