Pupillary pigment eversion

Introduction The iris can affect the proximal pupil edge of the adjacent tissue, causing the pupil to deform and the pupillary margin to eversion. But it does not mean that the iris is awkward. Iris sputum is a hamartomaous lesion that is a neoplastic mass composed of melanocytes with a benign cytological morphology. Pigmented nevus is generally stable and has no obvious growth tendency. Occasionally, malignant changes can occur. The reason is unknown, mostly congenital. Caucasians are more common than colored people. Patients with neurofibromatosis are often accompanied by multiple iris fistulas. Generally asymptomatic. The area near the pupil of the iris is prone to occur. Clinically, there are two types: focal iris sputum and diffuse iris sputum.

Cause

The reason is unclear and mostly congenital. Pathogenesis: A neoplastic mass composed of melanocytes in a benign cytological form.

an examination

Related inspection

Ultrasound examination of the eyeball and eyelid and CT examination of the temporal region

Histopathological findings: The pigmented nevus is mostly located in the shallow stromal layer of the iris and can be slightly raised in the anterior chamber. Most iris pigmented nevus is composed of well-differentiated small spindle-shaped sputum cells, or doped with a small number of small round sputum cells, which contain different amounts of melanin particles. This form of pigmented nevus is called spindle-shaped cytochrome. A small number of iris pigmented nevus is large. Dark black is mainly composed of large round melanocytes. The cytoplasm is rich in melanin particles. It is a melanoma or a large cell-like sputum. The fusiform cells usually adhere closely to each other and are not easy to fall off. However, loose adhesion between large round melanocytes is prone to spontaneous necrosis, shedding or involvement of iris corneal keratosis, leading to secondary glaucoma.

Other ancillary examinations: Ultrasound biomicroscopy: helps to differentiate from iris melanoma. The iris UBM is characterized by an abnormal ridge of the iris with clear but irregular boundaries. The internal reflection is uniform, and some cases have a "umbilical" change or a "crater"-like change. The posterior boundary of the lesion is not clear and may have a slight acoustic attenuation.

Differential diagnosis

Differential diagnosis of pupillary pigment valgus:

1. The vitreous body protrudes through the pupil to the front chamber: the vitreous body refers to the vitreous body protruding through the pupil to the front chamber. Common in cataract extraction after cataract extraction. When the vitreous hemorrhoids contact with the corneal endothelium, it is easy to cause corneal edema and turbidity.

2. Pupil deformation: The pupil deformation refers to the abnormal shape of the pupil, or the abnormal reaction of the pupils on both sides. Normally round, both sides are equal, and the responses of the pupils on both sides are synchronized. It can be elliptical in glaucoma or intraocular tumors; the shape can be irregular when the iris is stuck.

3, progressive iris atrophy: characterized by significant iris atrophy and different degrees of pupillary shift and ovarian valgus.

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