Posted December 1, 20159 yr In the maternity ward I sometimes come across babies with irregular pupillary shapes. Not like coloboma but the other way around - small black circles outline the pupil. Whenever I refer these findings to the ophtalmologist they don´t see it so I have´nt got a name for it. Does any of you have the same experience? Do you know what it is?
December 2, 20159 yr Interesting observation! Do you mean that the opthalmologist did not see the same at all or just did not have a name for it? I have some vague memories that there are more pigmentforming during the embryonic period - maybe this is some sort of overpigmentation remnant from fetal life?? Maybe you finns some clues here? http://www.ncbi.nlm.nih.gov/m/pubmed/3507670/
December 2, 20159 yr Author They dont see it at all which I think implies that it's a dynamic process (also making me look like a fool ;)). Once though when it was so pronounced in one baby that I thought vision might get impaired the ophtalmologist acknowledged it and would do a follow up. Even then I got no clear explanation of it. I think it could be a normal finding caused by some developmental remnant (as your article points toward)? Next time I find it, I will do a follow up myself after 2 weeks before I consult an ophtalmologist. Thank you
December 2, 20159 yr Tell the ophtalmologist - you got to see it to believe it! If you get permission/consent from parents - it would be great to share a photo around here. Maybe someone would not just bring some more confusion, like me...
January 13, 20169 yr Author Ectropion uvae according to the ophtalmologist. If you image-search the web for this I don´t think I find something that is spot on the appearance of my patients but I trust the opthalmologist...
December 14, 20186 yr Author Bumping this one... a very benign condition but for those interested Had antoher patient with these findings and I did som more digging on the topic.... It looks like it could be "Iris Flocculus/flocculi" I teamed up with the opthalmologist today to see that they would see what I saw and she did. They usually call it "epithelial cyst of the iris" and if it´s only on the margin of the pupil they dont check it further. If it´s bigger (like this one covering a third of the caudal part of the pupil) they have follow up checks. There are two Pictures showing iris flocculi in the link below In Figure 2 - A and B http://www.google.se/url?sa=i&rct=j&q=&esrc=s&source=images&cd=&ved=2ahUKEwiKs4mUj5_fAhWjAxAIHVV5BB0Q5TV6BAgBEAs&url=http%3A%2F%2Fwww.apjo.org%2FApjo%2FdownPDF%2Fid%2F462.html&psig=AOvVaw2CHiN8-FCSrDAlRPpuCl_R&ust=1544869834309802 I also found an old article from 1998 where they describe the phenomenon "Flocculus neonatorum" - a self resolving benign nodular flocculus of the Iris in the newborn. https://journals.sagepub.com/doi/abs/10.1177/000992289803700509?journalCode=cpja and they estimate it to be as common as 1 out of 30 newborns so I´m surprised that so few examiners recognise these findings Finally I can sleep peacefully
December 14, 20186 yr Great to bump this topic! I made a screen shot of the photo you referred to (below), did those infants have such marked "out-stamped areas" at the iris margin? I also looked into the first suggestion Ectropion uvae, and found something that seemed to look like your first drawing. Which one best illustrates your clinical finding?
December 14, 20186 yr Author Thanks for the pictures! I’ve seen the bottom picture before and that is the only picture of ”ectropion uveae” that looks similar to my findings, although a very mild variant. Mostly it looks like the upper pictures although not that extreme and not extending radially outwards onto the iris but only inwards, into the pupil.
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