PMC3615837_01
The right eye of case 1 demonstrates intermittent pupil capture of the IOL optic. The optic is initially behind the pupil (A), but becomes intermittently captured after a single blink (B). Postdilation slit-lamp photograph shows patchy transillumination defects with the superior IOL haptic and optic edge now visible (C). Ultrasound biomicroscopy (D) shows a concave I configuration and contact between the I and the IOL during PC.. Abbreviations: IOL, intraocular lens; I, iris; PC, pupil capture.
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The right eye also showed patchy transillumination defects throughout the iris stroma with intermittent pupil capture of the IOL optic (Figure 1A-C). Ultrasound biomicroscopy confirmed the concave iris configuration, as well as apposition of the iris with the IOL (Figure 1D).
Optic nerve photographs. Optic nerve photographs of the right (A) and left (B) eyes of case 1 demonstrate advanced cupping and pallor of the right eye with a healthy neuroretinal rim in the left eye. Visualization of the left optic nerve is slightly impaired due to the presence of a mature cataract. Automated visual field testing of the right (C) and left (D) eyes shows marked generalized depression in the right eye.. Note: The left eye was tested with a size V stimulus due to an advanced cataract, but shows a full field.
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The right optic nerve demonstrated advanced cupping and pallor compared to the left (Figure 2A and B). Automated Humphrey visual field testing showed marked generalized depression in the right eye and a relatively full field in the left (Figure 2C and D).
PMC3615837_02
Postdilation slit-lamp photo of the right eye of case 2 shows posterior pigment deposition on the posterior lens capsule (Scheie stripe), consistent with a diagnosis of primary pigment dispersion syndrome (A). Gonioscopy of the right eye shows an open angle with a concave iris configuration and 3+ uniform pigmentation of the trabecular meshwork (B).
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Slit-lampexam of the right eye demonstrated a clear cornea, round pupil without iris transillumination defects, a quiet anterior chamber, and pigment deposition on the posterior capsule of the crystalline lens (Scheie stripe; Figure 3).
Slit-lamp photo and gonioscopy of the left eye. Slit lamp photo of the left eye of case 2 shows a darkly pigmented 4.2 mm x 2.2 mm inferotemporal iris nevus (A). Gonioscopy of the left eye shows 4+ pigmentation of the trabecular meshwork (B).
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The left eye also showed a darker overall iris color and an inferotemporal pigmented iris mass (Figure 4A). The left eye showed 4+ pigmentation in the superior, nasal, and temporal quadrants with extremely heavy pigmentation inferiorly (Figure 4B); both irides were noted to have a markedly concave configuration. The left optic nerve showed marked cupping compared to the right eye with a dense inferior arcuate scotoma on automated visual field testing (Figure 5A-D).
Optic nerve photographs of the right and left eyes of case 2. Optic nerve photographs of the right (A) and left (B) eyes of case 2 demonstrate a healthy neuroretinal rim in the right eye and advanced cupping with thinning of the inferior and superior neuroretinal rim in the left eye. Automated visual field testing of the right (C) and left (D) eyes revealed an unremarkable field in the right eye and a dense inferior arcuate scotoma in the left eye on pattern standard deviation.
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The left eye showed 4+ pigmentation in the superior, nasal, and temporal quadrants with extremely heavy pigmentation inferiorly (Figure 4B); both irides were noted to have a markedly concave configuration. The left optic nerve showed marked cupping compared to the right eye with a dense inferior arcuate scotoma on automated visual field testing (Figure 5A-D).