Fuchs heterochromic iridocyclitis
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Through Autoimmunity
Presentation
This condition is usually unilateral, and its symptoms vary from none to mild blurring and discomfort. Signs include diffuse iris atrophy and small white keratic precipitates (deposits on the inner surface of the cornea), cells presenting in the anterior chamber as well as the anterior vitreous. Glaucoma and cataract occur frequently.
Complications
- Glaucoma
- Cataract
- Decreased visual acuity (vision loss)
- Iris atrophy
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Causes
According to recent research, no single theory is able to explain the cause fully. However current plausible theories include infection with Toxoplasma gondii, Herpes simplex virus, Rubella, neurogenic causes, and autoimmune pathology.
Diagnosis
Diagnosis is made by an ophthalmologist or optometrist based on the clinical presentation. One indication can be the Amsler sign, which is the presence of blood (hyphema) in the aspirated vitreous fluid, in paracentesis of the anterior chamber. This is caused due to iris atrophy usually seen in FHI and exposure of the fragile iris vasculature to the vitreous fluid. The sudden change of pressure in the anterior chamber upon suction induced by the paracentesis, or during cataract surgery, causes bursting of the fragile superficial iris capillaries resulting in micro-bleeding. This is one clinical diagnostic sign of FHI slit-lamp examination shows stringy keratic precipitates
Treatment
Patients usually do not require treatment due to the benign nature of the disease. In case a cataract develops, patients generally do well with cataract surgery.
History
First described using available patient presentations observed, by an Austrian ophthalmologist, Ernst Fuchs in 1906.