|Year : 1963 | Volume
| Issue : 3 | Page : 73-75
A case of irido-dialysis
KN Mathur, TP Agarwal
Department of Ophthalmology, Sarojini Naidu Medical College, Agra, India
|Date of Web Publication||28-Jan-2008|
K N Mathur
Department of Ophthalmology, Sarojini Naidu Medical College, Agra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Mathur K N, Agarwal T P. A case of irido-dialysis. Indian J Ophthalmol 1963;11:73-5
Irido-dialysis is a colobomatous defect affecting the peripheral border of the iris leaving the pupillary margins intact. It is an acquired condition and is seen either following trauma to the eye, or in extreme cases of atrophy of the iris, following iritis (in later life). Therefore, clinically it resembles irido-diastasis which is a congenital condition. As it is a rare condition following irridocyclitis a single case is being reported.
| Case Report|| |
Patient named S. I., aged 15 years, Hindu female, was admitted in this hospital on 23rd January, 1961 with the complaints of diminution of vision of the left eye for the last five years, which was noticed accidentally. There was no history of inflammation or trauma to the eye in the past. Other members of the family had no eye trouble.
She was a young girl of average build. [Figure - 3] shows the prominent left eye with wide palpebral fissure. The movements of the eve were normal. The anterior chamber was deep. As shown in [Figure - 1] the iris was atrophied and paper thin without any stromal markings. The holes at the periphery of the iris were present with well defined clear cut margins extending from 5 to 7 O'clock. The hole towards, 7 O'clock was biggest and was separated from the second hole by a fine strand of iris tissue. The other two holes were also close to each other separated by a fine strand of iris tissue, but away from the first two holes. A very small hole measuring about 1 m.m. in diameter was present in the iris at about 5 O'clock midway between the pupillary margin and the ciliary margin of the iris. The pupil was distorted in shape and pupillary reaction to light was very sluggish. In the centre of the pupil there was a lenticular opacity which was anterior polar with irregular margins. [Figure - 2] shows under slit-lamp examination the pigmentary deposits on the anterior surface of the lens and posterior synechia, more, so between 5 to 7 O'clock. The peripheral border of the lens with attached zonules, was seen through the biggest hole towards 7 O'clock. No synechia or pigmentary deposits were seen either on the zonules or on the lens surface through the colobomatous defects. Details of the fundus were not visible due to the lenticular opacity. Tension was 62 m.m. Of Hg (Schiotz) in the left eye as compared to the right eye in which it was 20 m.m. Of Hg. (Schiotz). Vision in the left eye was finger counting at 1 ft, from the temporal side of the field of vision. The other eye was normal with 616 (Snellen's chart) vision. Systematic examination of the. body did not reveal any other abnormality.
X-Ray, laboratory investigations. dermal and serological tests were noncontributory.
| Discussion|| |
Dehiscences may occur in iris stroma ill extreme cases of atrophy following iritis so that actual holes are formed, an occurrence usually preceded by the presence of synechia and a rise of pressure in the posterior chamber. As a rule such holes are formed in the thinner part of iris near its attachment, so that a. nontraumatic atrophic irido-dialysis results (Duke Elder, 1940).
This patient must have had an attack of iritis some time back in the left eye following which, she developed posterior synechia most marked between 5 to 7 O'clock position, deep anterior chamber, raised intra-ocular tension, iris atrophy, lenticular opacity and diminution of vision. The fibrous tissue formed in iris stroma underwent contraction during the healing stage. As the iris was already fixed at thee pupillary border between 5 to 7 O'clock position, it was torn at its thinnest part near its attachment with the ciliary body resulting in multiple holes in the iris, through which the lens border and the zonules could be seen on slit-lamp examination. Such colobomatous defects were not present in other segments of the iris, where it was not adherent with the lens at the pupillary border, though atrophy of the iris was present all over, That these colobomatous defects are late sequelae of healed iritis is further strengthened by the fact that no pigmentary synechia or pigmentary spots were present either on the zonules or on the lens seen through them. The small hole in iris stroma midway between pupillary and ciliary border at 5 O'clock position is clue directly to marked atrophy of the iris.
| Summary|| |
A case of unilateral irido-dialysis following iritis is being reported in a girl of 15 years of age.
| References|| |
Duke-Elder, W. S. (1940), "The Text book of Ophthalmology, Vol, 3, p. 2185, Henry Kimpton, London, (St, Louis Mosby).
[Figure - 1], [Figure - 2], [Figure - 3]