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An iris cyst, or uveal cyst, is a small hollow structure either attached to the iris of the eye or floating free in the anterior chamber. An iris cyst is composed of a single cell layer of epithelium and is filled with fluid. It is most commonly seen as secondary to inflammation in the eye, especially with canine glaucoma. They are most commonly seen in dogs. Golden Retrievers, Labrador Retrievers, and Boston Terriers are the most commonly affected breeds. Iris cysts also occur in cats and horses. The cysts are usually free floating in dogs, attached to the pupillary margin in cats, and present in the interior of the iris (especially blue irises) in horses.
Iris cysts usually cause no symptoms, but in large numbers they can cause glaucoma by obstructing the drainage angle of the eye. Golden Retrievers may have a higher rate of glaucoma associated with iris cysts.
Iris cysts need to be differentiated from iris melanoma, a tumor, by demonstrating their hollowness. A light directed at an iris cyst will cause it to transilluminate. Iris cysts can be collapsed if necessary by a veterinarian with a small needle carefully introduced into the anterior chamber. The cysts may also be destroyed by use of a semiconductor diode laser.
The disease is chronic and often progresses slowly. Prognosis is generally poor when associated with glaucoma [1,2].
Plateau iris is a medical condition of the eye resulting from pushing of peripheral part of iris forward, by the large or anteriorly placed ciliary body causing angle closer glaucoma.
http://image.slidesharecdn.com/gonioscopy-140211072931-phpapp01/95/gonioscopy-70-638.jpg?cb=1392103893
this configuration is usually corrected by iridectomy.
if the glaucoma persists even after iridectomy then it is called plateau iris syndrome, this is managed by miotics or laser peripheral iridoplasty
Iridocorneal Endothelial (ICE) syndromes are a spectrum of diseases characteriezed by slowly progressive abnormalities of the corneal endothelium and features including corneal edema, iris distortion, and secondary angle-closure glaucoma. [1,2,4] ICE syndromes are predominantly unilateral and nonhereditary [1,2,4]. The condition occurs in predominantly middle-aged women [1,3,4].
Scientists are studying different populations and relationships to try to learn more about the disease. They have found associations with different groups but it is not yet clear what the underlying factors are and how they affect different peoples around the world.
- Glaucoma patients. While PEX and glaucoma are believed to be related, there are cases of persons with PEX without glaucoma, and persons with glaucoma without PEX. Generally, a person with PEX is considered as having a risk of developing glaucoma, and vice versa. One study suggested that the PEX was present in 12% of glaucoma patients. Another found that PEX was present in 6% of an "open-angle glaucoma" group. Pseudoexfoliation syndrome is considered to be the most common of identifiable causes of glaucoma. If PEX is diagnosed without glaucoma, there is a high risk of a patient subsequently developing glaucoma.
- Country and region. Prevalence of PEX varies by geography. In Europe, differing levels of PEX were found; 5% in England, 6% in Norway, 4% in Germany, 1% in Greece, and 6% in France. One contrary report suggested that levels of PEX were higher among Greek people. One study of a county in Minnesota found that the prevalence of PEX was 25.9 cases per 100,000 people. It is reportedly high in northern European countries such as Norway, Sweden and Finland, as well as among the Sami people of northern Europe, and high among Arabic populations, but relatively rare among African Americans and Eskimos. In southern Africa, prevalence was found to be 19% of patients in a glaucoma clinic attending to persons of the Bantu tribes.
- Race. It varies considerably according to race.
- Gender. It affects women more than men. One report was that women were three times more likely than men to develop PEX.
- Age. Older persons are more likely to develop PEX. And persons younger than 50 are highly unlikely to have PEX. A study in Norway found that the prevalence of PEX of persons aged 50–59 was 0.4% while it was 7.9% for persons aged 80–89 years. If a person is going to develop PEX, the average age in which this will happen is between 69 and 75 years, according to the Norwegian study. A second corroborating report suggested that it happens primarily to people 70 and older. While older people are more likely to develop PEX, it is not seen as a "normal" part of aging.
- Other diseases. Sometimes PEX is associated with the development of medical problems other than merely glaucoma. There are conflicting reports about whether PEX is associated with problems of the heart or brain; one study suggested no correlations while other studies found statistical links with Alzheimer's disease, senile dementia, cerebral atrophy, chronic cerebral ischemia, stroke, transient ischemic attacks, heart disease, and hearing loss.
According to recent research not a 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.
Patients usually do not require treatment due to benign nature of the disease. In case cataract develops patients generally do well with cataract surgery.
The cause of pseudoexfoliation glaucoma is generally unknown.
PEX is generally believed to be a systemic disorder, possibly of the basement membrane of the eye. Researchers have noticed deposits of PEX material in various parts of the body, including in the skin, heart, lungs, liver, kidneys, and elsewhere. Nevertheless, what is puzzling is that PEX tends to happen in only one eye first, which scientists call "unilaterality", and in some cases, gradually afflicts the other eye, which is termed "bilaterality". According to this reasoning, if PEX were a systemic disorder, then both eyes should be affected at the same time, but they are not. There are contrasting reports about the extent and speed with which PEX moves from one eye to both eyes. According to one report, PEX develops in the second eye in 40% of cases. A contrasting report was that PEX can be found in both eyes in almost all situations if an electron microscope is used to examine the second eye, or if a biopsy of the conjunctiva was done, but that the extent of PEX is the second eye was much less than the first one. A different report suggested that two thirds of PEX patients had flakes in only one eye. In one long term study, patients with PEX in only one eye were studied, and it was found that over time, 13% progressed to having both eyes afflicted by PEX. Scientists believe that elevated levels of plasma homocysteine are a risk factor for cardiovascular disease, and two studies have found higher levels of plasma homocysteine in PEX patients, or elevated homocysteine concentrations in tear fluids produced by the eye.
There is speculation that PEX may be caused by oxidative damage and the presence of "free radicals", although the exact nature of how this might happen is still under study. Studies of PEX patients have found a decrease in the concentrations of ascorbic acid, increase in concentrations of malondialdehyde, and an increase in concentrations of 8-iso-prostaglandinF2a.
There is speculation that genetics may play a role in PEX. A predisposition to develop PEX later in life may be an inherited characteristic, according to one account. One report suggested the genetic component was "strong". One study performed in Iceland and Sweden has associated PEX with polymorphisms in gene LOXL1. A report suggested that a specific gene named LOXL1 which was a member of the family of enzymes which play a role in the linking of collagen and elastin inside cells. LOXL1 was responsible for "all the heritability" of PEX, according to one source. Two distinct mutations in which a single nucleotide was changed, or called a "single nucleotide polymorphism" or SNP, was discovered in Scandinavian populations and confirmed in other populations, and may be involved with the onset of PEX.
Researchers are investigating whether factors such as exposure to ultraviolet light, living in northern latitudes, or altitude influence the onset of PEX. One report suggested that climate was not a factor related to PEX. Another report suggested a possible link to sunlight as well as a possible autoimmune response, or possibly a virus.
Predisposing factors for Postoperative PVR are preoperative PVR, aphakia, high levels of vitreous proteins, duration of retinal detachment before corrective surgery, the size of the retinal hole or tear, intra-ocular inflammation, vitreous hemorrhage, and trauma to the eye. An equation to calculate the patient's risk for acquiring PVR is:
1 is added if the risk factor is present and 0 if the risk factor is absent. A patient is at a high risk for developing PVR is the PVR score is >6.33.
Asteroid hyalosis is a degenerative condition of the eye involving small white opacities in the vitreous humor. It is known to occur in humans, dogs, cats, horses, and chinchillas. Clinically, these opacities are quite refractile, giving the appearance of stars (or asteroids) shining in the night sky—except that ocular asteroids are often quite mobile. Ocular asteroids must be distinguished from the more common typical vitreous floaters, which are usually fibrillar or cellular condensates. The cause of asteroid hyalosis is unknown, but it has been associated with diabetes mellitus, hypertension, hypercholesterolemia, and, in certain animals, tumors of the ciliary body. In dogs, asteroid hyalosis is considered to be an age related change. The asteroid bodies are made up of hydroxylapatite, which in turn consists of calcium and phosphates or phospholipids. While asteroid hyalosis does not usually severely affect vision, the floating opacities can be quite annoying, and may interfere significantly with visualization and testing of the retina. While treatment of asteroid hyalosis is usually unnecessary, vitrectomy may occasionally be indicated, for both diagnostic and therapeutic purposes.
Terrier breeds are predisposed to lens luxation, and it is probably inherited in the Sealyham Terrier, Jack Russell Terrier, Wirehaired Fox Terrier, Rat Terrier, Teddy Roosevelt Terrier, Tibetan Terrier, Miniature Bull Terrier, Shar Pei, and Border Collie. The mode of inheritance in the Tibetan Terrier and Shar Pei is likely autosomal recessive. Labrador Retrievers and Australian Cattle Dogs are also predisposed.
The pressure within the eye is maintained by the balance between the fluid that enters the eye through the ciliary body and the fluid that exits the eye through the trabecular meshwork.
Rubeosis iridis, also called neovascularization of the iris (NVI), is a medical condition of the iris of the eye in which new abnormal blood vessels (formed by neovascularization) are found on the surface of the iris.
Many people of East Asian descent are prone to developing angle closure glaucoma due to shallower anterior chamber depths, with the majority of cases of glaucoma in this population consisting of some form of angle closure. Higher rates of glaucoma have also been reported for Inuit populations, compared to white populations, in Canada and Greenland.
The number of cases is around 0.5 to 0.7 per 10,000 births, making it a relatively rare condition.
A synechia is an eye condition where the iris adheres to either the cornea (i.e. "anterior synechia") or lens (i.e. "posterior synechia"). Synechiae can be caused by ocular trauma, iritis or iridocyclitis and may lead to certain types of glaucoma. It is sometimes visible on careful examination but usually more easily through an ophthalmoscope or slit-lamp.
Anterior synechia causes closed angle glaucoma, which means that the iris closes the drainage way of aqueous humour which in turn raises the intraocular pressure. Posterior synechia also cause glaucoma, but with a different mechanism. In posterior synechia, the iris adheres to the lens, blocking the flow of aqueous humor from the posterior chamber to the anterior chamber. This blocked drainage raises the intraocular pressure.
This may be present in conditions causing traction on the retina especially at the macula. This may occur in:
a) The vitreomacular traction syndrome; b) Proliferative diabetic retinopathy with vitreoretinal traction; c) Atypical cases of impending macular hole.
No clear evidence indicates vitamin deficiencies cause glaucoma in humans. It follows, then, that oral vitamin supplementation is not a recommended treatment for glaucoma. Caffeine increases intraocular pressure in those with glaucoma, but does not appear to affect normal individuals.
This condition is often associated with diabetes in advanced proliferative diabetic retinopathy. Other conditions causing rubeosis iridis include central retinal vein occlusion, ocular ischemic syndrome, and chronic retinal detachment.
Ocular hypertension is the presence of elevated fluid pressure inside the eye (intraocular pressure), usually with no optic nerve damage or visual field loss.
For most individuals, the normal range of introcular pressure is between 10 mmHg and 21 mmHg. Elevated intraocular pressure is an important risk factor for glaucoma. The Ocular Hypertension Treatment Study, a large, multicentered, randomized clinical trial, determined that topical ocular hypotensive medication delays or prevents the onset of Primary Open-Angle Glaucoma. Accordingly, most individuals with consistently elevated intraocular pressures of greater than 21mmHg, particularly if they have other risk factors, are treated in an effort to prevent vision loss from glaucoma.
Lens subluxation is also seen in dogs and is characterized by a partial displacement of the lens. It can be recognized by trembling of the iris (iridodonesis) or lens (phacodonesis) and the presence of an aphakic crescent (an area of the pupil where the lens is absent). Other signs of lens subluxation include mild conjunctival redness, vitreous humour degeneration, prolapse of the vitreous into the anterior chamber, and an increase or decrease of anterior chamber depth. Removal of the lens before it completely luxates into the anterior chamber may prevent secondary glaucoma. A nonsurgical alternative involves the use of a miotic to constrict the pupil and prevent the lens from luxating into the anterior chamber.
As the name implies, it is the bulge of weak sclera lined by ciliary body, which occurs about 2–3 mm away from the limbus. Its common causes are thinning of sclera following perforating injury, scleritis & absolute glaucoma.
it is part of anterior staphyloma
It is the name given to the localised bulge in limbal area, lined by the root of the iris. It results due to ectasia of weak scar tissue formed at the limbus, following healing of a perforating injury or a peripheral corneal ulcer. There may be associated secondary angle closure glaucoma, may cause progression of the bulge if not treated. Defective vision occurs due to marked corneal astigmatism. Treatment consists of localised staphylectomy under heavy doses of oral steroids.
Leukocoria (also leukokoria or white pupillary reflex) is an abnormal white reflection from the retina of the eye. Leukocoria resembles eyeshine, but leukocoria can occur in humans and other animals that lack eyeshine because their retina lacks a "tapetum lucidum".
Leukocoria is a medical sign for a number of conditions, including Coats disease, congenital cataract, corneal scarring, melanoma of the ciliary body, Norrie disease, ocular toxocariasis, persistence of the tunica vasculosa lentis (PFV/PHPV), retinoblastoma, and retrolental fibroplasia.
Because of the potentially life-threatening nature of retinoblastoma, a cancer, that condition is usually considered in the evaluation of leukocoria. In some rare cases (1%) the leukocoria is caused by Coats' disease (leaking retinal vessels).
Mydriatic/cycloplegic agents, such as topical homatropine, which is similar in action to atropine, are useful in breaking and preventing the formation of posterior synechia by keeping the iris dilated and away from the crystalline lens. Dilation of the pupil in an eye with the synechia can cause the pupil to take an irregular, non-circular shape (Dyscoria) as shown in the photograph. If the pupil can be fully dilated during the treatment of iritis, the prognosis for recovery from synechia is good. This is a treatable status.
To subdue the inflammation, use topical corticosteroids. If the intra-ocular pressure is elevated then use a PGA such as Travatan Z.