Welcome to Case of the Day!
Today, we’re going to discuss a sort of rare and interesting case. A patient came in for a follow-up after cataract surgery. Prior to cataract surgery, Dr. Croley had been following this patient for a condition called iridoschisis (iris schisis).
The iris is the blue or brown part of your eye, and “schisis” is a division. In this condition, the layers of your iris split, so the anterior stromal layer splits from the posterior layers and the muscle, and you see these fibers detaching and then floating around in the anterior chamber.
This is a very, very, very rare case, and over time, the patient developed a cataract, and we ended up doing cataract surgery, and she’s in for a follow-up visit. It was definitely a very interesting cataract operation with all this iris material flying around inside her eye while we’re doing the surgery, but she’s done very well. This is also associated with glaucoma, so people who have this iris schisis tend to have glaucoma, or maybe even angle closure glaucoma, because this material can then maybe plug up or block the meshwork where the fluid drains out of your eye. The fluid is produced by the ciliary body behind your iris, goes in front of the lens, goes through your pupil, fills up the front of your eye, and is drained in the angle through the trabecular meshwork into Schlemm’s canal, then out through a vein from your eye. If this gets blotted, then suddenly the eye pressure can get out of control and go from a normal range of 10 or 21 to as much as 60 or 70, and that’s a severe acute emergency that people can lose their vision from that episode.
Other things that can mimic this a little bit are Axenfeld–Rieger syndrome (ARS), which is a congenital abnormality, so this person didn’t have that because they weren’t born with this condition, and then iridocorneal endothelial (ICE) dystrophy is another type of syndrome, but this usually occurs later in life—in the 70s, 80s—and is bilateral. This lady was 55 years old, and this was a unilateral case.
If someone has glaucoma and you see the iris breaking loose and your stromal fibers coming loose, that is called schisis, and in this case, iridoschisis or iris schisis.
If you have any questions about this or any other cases or problems, contact the Cataract & Refractive Institute of Florida. If not, may God grant you healthy eyes and great vision.
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Dr. Croley is the kind of doctor who takes time to listen, answer every question, and explain things in a way that’s easy to understand. He’s incredibly thorough and clearly passionate about what he does. I never feel rushed — he makes sure everything is done right and that I’m completely comfortable before I leave.
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If you’re looking for an eye doctor who combines skill, kindness, and professionalism, Dr. Croley is absolutely the one to see. I’m so grateful to my father to have recommended him to me."
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At the Cataract & Refractive Institute of Florida, our board-certified ophthalmologist uses state-of-the-art tools and techniques to help patients manage their eye issues and vision problems. Schedule an appointment online or call our office near you!
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