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Year : 1955  |  Volume : 3  |  Issue : 1  |  Page : 11-12

Two unusual cases of heterochromia

Mahatma Gandhi Memorial Medical College, Indore, India

Correspondence Address:
R P Dhanda
Mahatma Gandhi Memorial Medical College, Indore
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How to cite this article:
Dhanda R P. Two unusual cases of heterochromia. Indian J Ophthalmol 1955;3:11-2

How to cite this URL:
Dhanda R P. Two unusual cases of heterochromia. Indian J Ophthalmol [serial online] 1955 [cited 2021 May 15];3:11-2. Available from: https://www.ijo.in/text.asp?1955/3/1/11/33568

Reference to the description of heterochromia in literature gives one an im­pression that the term simple heterochromia indicates that iris of one eye is of a uniform colour and that of the other eye is of another uniform colour. The two cases described below appear to be of an unusual nature as compared to the description in text books and therefore according to the history and description we have called the first as "Partial Simple Heterochromia" and the second as "Progressive Simple Heterochromia".

In both these cases the possibility of complicated heterochromia was excluded by thorough eye examination. There was also no obvious lesion of the sympa­thetic chain nor any disease of the iris tissue, and so the possibilities of neuro­genic and atrophic heterochromia were also excluded.

A modified classification of Heterochromia is therefore suggested as follows: -

I. Simple heterochromia : -

(i) Static heterochromia : -

(a) complete static heterochromia. (b) partial static heterochromia.

(ii) Progressive heterochromia:­

II. Complicated heterochromia : -

(i) cyclitic heterochromia.

(ii) atrophic heterochromia.

(iii) neurogenic heterochromia.

  Case Reports Top

I. A case of "Partial Static Heterochromia":

Salim, a male child, 4˝ years old, was referred in June 1951 for internal squint of right eye of 1˝ years' duration.

On routine examination the colour of the two irides was found to be dis­similar. On more careful examination, the right iris was found to be of a uniform light brown colour, whereas in the left eye, part of the iris was light brown in colour and part of it was blue [Figure - 1]. This heterochromia was present from birth and was not progressive.

Biomicroscopic examination revealed no signs of cyclitis. Lenses were clear and fundii normal. There was no error of refraction in either eye. The internal squint was due to paralysis of right external rectus.

Family history : This child had one brother and one sister, both of whom had dark brown irides. No other member in the family had heterochromia, and only the grandfather of the child had blue irides.

We have used the term "partial simple heterochromia" for the above case to distinguish it from "heterochromia" as the latter term suggests a uniformly different colour between the two eyes.

It will be interesting to observe if the partial simple heterochromia of the child becomes a full heterochromia later in life.

II. A case of "Progressive Simple Heterochromia"

Panduranga, a male child, 5 years old was brought on 30-11-51 with the history that a few days after birth the parents noted a blue streak in the left eye in the otherwise dark brown irides of both the eyes. As the child grew up, more and morel iris of left eye became blue in colour till at the age of 4 years, the whole of the left iris was of blue colour. Subsequently blue streaks appeared in the right iris also and have progressed to the present stage [Figure - 2].

Family history could not be elicited beyond the third pedigree and among these there was no case of blue irides or of heterochromia.

Media were clear. There were no signs of cyclitis nor any lens opacities. In the periphery of the left fundus large plaques of melanomatous patches were seen all round, as if the pigment from the iris had migrated and deposited on the fundus. Otherwise the discs, macula and blood vessels were normal.


  [Figure - 1], [Figure - 2]


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