A 29 year-old woman had visual loss following ingestion of 6 g of quinine in a suicide attempt in 1965. Her visual acuity rapidly deteriorated to light perception bilaterally, but recovered to 6/9 in both eyes within a month. She had residual nyctalopia and dyschromatopsia. In the following years the irides developed progressive, diffuse atrophy. The pupils became miotic, oval and nonreactive (Figure 1). There was marked depigmentation of the iris stroma and pigment epithelium, similar to that seen in ocular albinism (Figure 2). There was bilateral disc pallor and diffuse retinal vascular narrowing. An electroretinogram was done in 1978 and showed a flat photopic response and a scotopic response with an absent b-wave. Goldman perimetry (1978) showed a constricted visual field of 20° with a V4 target. Her visual acuity in 2005 was 6/36 in the right eye due to age-related cataract and 6/9 in the left eye.
Slitlamp photographs taken in 2005 showing blue irides with horizontally oval pupils. A indicates right eye; B, left eye.
Extensive iris transillumination is seen with coaxial light. A indicates right eye; B, left eye.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Ophthalmology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.