2020–2021 BCSC Basic and Clinical Science Course™
6 Pediatric Ophthalmology and Strabismus
Part II: Pediatric Ophthalmology
Chapter 21: Disorders of the Anterior Segment
Miscellaneous Clinical Signs
Pediatric Iris Heterochromia
The differential diagnosis of pediatric iris heterochromia is extensive. Causes can be classified based on whether the condition is congenital or acquired and whether the affected eye is hypopigmented or hyperpigmented (Fig 21-22, Table 21-3). Trauma, chronic iridocyclitis, intraocular surgery, and use of topical prostaglandin analogues are important causes of acquired hyperpigmented heterochromia. Whether congenital or acquired, hypopigmented heterochromia that is associated with a more miotic pupil and ptosis on the ipsilateral side should prompt a workup for Horner syndrome.
Figure 21-22 Iris heterochromia. The left iris has become darker since development of a traumatic cataract.
(Courtesy of John W. Simon, MD.)
Table 21-3 Causes of Pediatric Iris Heterochromia
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.