Fuchs heterochromic iridocyclitis
Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia, predisposition to cataract and glaucoma, and keratitis precipitates on the posterior corneal surface.
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FHI is a chronic unilateral uveitis with a characteristic triad of findings.
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Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia , predisposition to cataract and glaucoma , and keratitis precipitates on the posterior corneal surface.
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Patients are often asymptomatic and the disease is discovered incidentally.
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Patients are often asymptomatic and the disease is often discovered through investigation of the cause of the heterochromia or cataract.
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Neovascularisation may occur and eye surgery can precipitate hyphema.
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Neovascularisation (growth of new abnormal vessels) is possible and any eye surgery, such as cataract surgery, can cause bleeding from the fragile vessels in the atrophic iris causing accumulation of blood in the anterior chamber of the eye, also known as hyphema
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The condition was first described by Ernst Fuchs in 1906.
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First described using available patient presentations observed, by an Austrian ophthalmologist , Ernst Fuchs in 1906.
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Symptoms range from none to mild blurring and discomfort.
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its symptoms vary from none to mild blurring and discomfort
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Signs include diffuse iris atrophy.
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Signs include diffuse iris atrophy
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Small white keratic precipitates appear on the inner corneal surface.
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small white keratic precipitates (deposits on the inner surface of the cornea)
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Cells are present in the anterior chamber and anterior vitreous.
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cells presenting in the anterior chamber as well as the anterior vitreous
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Glaucoma and cataract occur frequently.
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Glaucoma and cataract occur frequently.
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Diagnosis is clinical, made by an ophthalmologist or optometrist.
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Diagnosis is made by an ophthalmologist or optometrist based on the clinical presentation.
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The Amsler sign—hyphema in aspirated vitreous fluid during paracentesis—is a diagnostic indicator.
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One indication can be the Amsler sign , which is the presence of blood (hyphema) in the aspirated vitreous fluid , in paracentesis of the anterior chamber
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Slit-lamp examination reveals stringy keratic precipitates.
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slit-lamp examination shows stringy keratic precipitates
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Treatment is usually unnecessary due to the benign nature of the disease.
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Patients usually do not require treatment due to the benign nature of the disease.
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Cataract surgery is generally well tolerated if cataract develops.
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In case a cataract develops, patients generally do well with cataract surgery.
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Neovascularisation can occur, and eye surgery may cause hyphema due to fragile iris vessels.
source quote
Neovascularisation (growth of new abnormal vessels) is possible and any eye surgery, such as cataract surgery, can cause bleeding from the fragile vessels in the atrophic iris causing accumulation of blood in the anterior chamber of the eye, also known as hyphema
The disease is benign in nature; patients generally do well with cataract surgery if needed.
| Fuchs heterochromic iridocyclitis | |
|---|---|
| Specialty | Ophthalmology |
Fuchs heterochromic iridocyclitis (FHI) is a chronic unilateral uveitis appearing with the triad of heterochromia, predisposition to cataract and glaucoma, and keratitis precipitates on the posterior corneal surface. Patients are often asymptomatic and the disease is often discovered through investigation of the cause of the heterochromia or cataract. Neovascularisation (growth of new abnormal vessels) is possible and any eye surgery, such as cataract surgery, can cause bleeding from the fragile vessels in the atrophic iris causing accumulation of blood in the anterior chamber of the eye, also known as hyphema.
This condition is usually unilateral, and its symptoms vary from none to mild blurring and discomfort. Signs include diffuse iris atrophy and small white keratic precipitates (deposits on the inner surface of the cornea), cells presenting in the anterior chamber as well as the anterior vitreous. Glaucoma and cataract occur frequently.[citation needed]
Complications
Complications are as follows:[citation needed]
- Glaucoma
- Cataract
- Decreased visual acuity (vision loss)
- Iris atrophy
According to recent research, no single theory is able to explain the cause fully. However current plausible theories include infection with Toxoplasma gondii, Herpes simplex virus, Rubella, neurogenic causes, and autoimmune pathology.[1]
Diagnosis is made by an ophthalmologist or optometrist based on the clinical presentation. One indication can be the Amsler sign, which is the presence of blood (hyphema) in the aspirated vitreous fluid, in paracentesis of the anterior chamber. This is caused due to iris atrophy usually seen in FHI and exposure of the fragile iris vasculature to the vitreous fluid. The sudden change of pressure in the anterior chamber upon suction induced by the paracentesis, or during cataract surgery, causes bursting of the fragile superficial iris capillaries resulting in micro-bleeding. This is one clinical diagnostic sign of FHI slit-lamp examination shows stringy keratic precipitates[citation needed]
Patients usually do not require treatment due to the benign nature of the disease. In case a cataract develops, patients generally do well with cataract surgery.[citation needed]
First described using available patient presentations observed, by an Austrian ophthalmologist, Ernst Fuchs in 1906.[citation needed]
- ↑ Maghsoudlou, P; Epps, SJ; Guly, CM; Dick, AD (28 May 2025). "Uveitis in Adults: A Review". JAMA. doi:10.1001/jama.2025.4358. PMID 40434762.
- American academy of ophthalmology (2012). Basic&clinical science course: Intraocular inflammation and uveitis (2011-2012 ed.). ISBN 978-1615251162.