Case Study 167 Iris Cysts

Abstract

RP is a 22-year-old woman who was seen by her optometrist for a routine eye examination. She was noted on slit-lamp inspection to have a bulge in the left temporal iris. Her pupil was dilated, and no retroiridial or ciliary mass could be detected. Transillumination was performed and no pigmented lesion was seen.

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RP is a 22-year-old woman who was seen by her optometrist for a routine eye examination. She was noted on slit-lamp inspection to have a bulge in the left temporal iris. Her pupil was dilated, and no retroiridial or ciliary mass could be detected. Transillumination was performed and no pigmented lesion was seen.

Immersion echography was performed with both 20- and 50-MHz probes. One larger and several smaller iris cysts were seen (Fig. 1). The patient was reassured that this was a benign lesion without any evidence of malignancy.

Fig. 1

Ultrasound biomicroscopy of large ciliary body cyst (large arrow) and several smaller cysts (small arrow)

Large pigment epithelial cysts may displace the iris anteriorly resulting in angle-closure glaucoma. They mechanically push the iris forward and narrow the angle. Marigo et al. state that when multiple cysts involve more than 180° of the iris, then angle closure with elevated intraocular pressure may develop [69]. This occurs in about 10 % of patients with these cysts.