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Photo Essay |

Laser Photocoagulation of Primary Central Pigment Epithelial Iris Cysts

Eamon W. Leung, MD; Jay R. Mehta, MD; Christopher R. Croasdale, MD
Arch Ophthalmol. 2005;123(9):1276. doi:10.1001/archopht.123.9.1276.
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A 13-year-old girl had been bothered for several years by increasing episodes of transitory “blindness” in her right eye. These usually occurred outdoors under bright, sunny conditions. One year earlier, she had been diagnosed as having iris cysts. Therapy with the mydriatics 1% tropicamide and 2.5% phenylephrine hydrochloride achieved no perceptible effect. She had no other history of use of ocular medications.

On examination, her best-corrected visual acuity was 20/25 OD and 20/2. OS. With bright light, the vision in her right eye decreased to less than 20/400. Slitlamp examination showed multiple, dark-brown iris pigment epithelial cysts along the pupillary margin of the right eye, with the visual axis open when the pupil was not fully constricted (figure 1). Obstruction of the visual axis by the cysts was easily demonstrated by using brighter illumination (figure 2).

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figure 1. Slitlamp photograph of the patient’s right pupil under moderate illumination. The iris cysts do not occlude the visual axis.

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figure 2. With the use of a wider slitlamp beam, the pupillary cysts obstruct the central visual axis of the patient’s right eye.

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Figure 3. One day after argon laser photocoagulation, the cysts have been ruptured and markedly shrunk.

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