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Year : 2019  |  Volume : 57  |  Issue : 2  |  Page : 180-181

Unilateral megalocornea associated with Fuchs' heterochromic iridocyclitis


Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India

Date of Web Publication10-Sep-2019

Correspondence Address:
Dr. Muthukrishnan Vallinayagam
No. 114, Inner Ring Road, Flat A4, Triumph Apartments, Arumbakkam, Chennai - 600 106, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_31_19

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  Abstract 


Fuchs' heterochromic iridocyclitis is an atypical form of chronic nongranulomatous anterior uveitis and is almost always unilateral. It presents with cataract, mild anterior chamber reaction, diffuse stellate keratic precipitates, absence of posterior synechiae, iris hypochromia and glaucoma. It is usually bilateral but may be asymmetrical. Unilateral megalocornea has been reported in a case of lamellar icthyosis. Slit lamp evaluation of right eye of a 70 year old revealed diffusely distributed fine, stellate white keratic precipitates, mild anterior chamber reaction and hypermature morgagnian cataract. Examination also revealed large cornea in right eye with normal pachymetry and keratometry values.

Keywords: Fuchs' heterochromic iridocyclitis, hypermature morgagnian cataract, megalocornea


How to cite this article:
Vallinayagam M, Anudeep K, Balla SC, Sahu J. Unilateral megalocornea associated with Fuchs' heterochromic iridocyclitis. TNOA J Ophthalmic Sci Res 2019;57:180-1

How to cite this URL:
Vallinayagam M, Anudeep K, Balla SC, Sahu J. Unilateral megalocornea associated with Fuchs' heterochromic iridocyclitis. TNOA J Ophthalmic Sci Res [serial online] 2019 [cited 2019 Sep 16];57:180-1. Available from: http://www.tnoajosr.com/text.asp?2019/57/2/180/266387




  Introduction Top


Fuchs' heterochromic iridocyclitis is an atypical form of chronic nongranulomatous anterior uveitis and is almost always unilateral.[1] It accounts for 1%–6% of all uveitis.[2] It presents with cataract, mild anterior chamber reaction, diffuse stellate keratic precipitates, absence of posterior synechiae, iris hypochromia, and glaucoma. Megalocornea is an uncommon congenital anomaly, in which the entire anterior segment is abnormally enlarged. Cataract is a well-known association.[3] It is usually bilateral, but may be asymmetrical. Unilateral megalocornea has been reported in a case of lamellar ichthyosis.[4]


  Case Report Top


A 70-year-old male presented with a gradual loss of vision in the right eye (RE) for 2 years. Ocular examination revealed visual acuity of hand movements in the RE. RE showed large cornea with diameter of 15 mm horizontally and 14.5 mm vertically [Figure 1]. Slit-lamp evaluation of the RE revealed diffusely distributed fine, stellate white keratic precipitates; mild anterior chamber reaction; and hypermature morgagnian cataract [Figure 1]. Intraocular pressure was 27 mmHg. Keratometry values were as follows: for RE, K1 = 42.50 and K2 = 43.25 and for left eye (LE), K1 = 43.25 and K2 = 43.75. Pachymetry values were 525 μ in the RE and 520 μ in the LE. Examination of the LE was essentially normal.
Figure 1: Megalocornea with fine, stellate white keratic precipitates and hypermature morgagnian cataract

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  Conclusion Top


The case is highlighted for unilateral presentation of megalocornea. This is a previously unrecorded association and the first report of Fuchs' heterochromic iridocyclitis in a patient with unilateral megalocornea.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given his consent for his images and other clinical information to be reported in the journal. The patient understands that his name and initials will not be published and due efforts will be made to conceal identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Couto C, Hurtado E, Faingold D, Demetrio C, Schlaen A, Zas M, et al. Atypical bilateral Fuchs uveitis: Diagnostic challenges. Case Rep Ophthalmol 2015;6:284-8.  Back to cited text no. 1
    
2.
Nalçacıoǧlu P, Çakar Özdal P, Şimşek M. Clinical characteristics of Fuchs' uveitis syndrome. Turk J Ophthalmol 2016;46:52-7.  Back to cited text no. 2
    
3.
Berry-Brincat A, Chan TK. Megalocornea and bilateral developmental cataracts. J Cataract Refract Surg 2008;34:168-70.  Back to cited text no. 3
    
4.
Mansour AM, Traboulsi EI, Frangieh GT, Jarudi N. Unilateral megalocornea in lamellar ichthyosis. Ann Ophthalmol 1985;17:466-8, 470.  Back to cited text no. 4
    


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