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Ophthalmology and Visual Sciences

Iris pigment epithelial cysts

Iris pigment epithelial cysts

Category(ies): Glaucoma, Iris
Contributors: Matt Ward, MD (figure 1); Thomas J.E. Clark, MD (figure 2)
Photographer: Brice Critser, CRA (figure 2)

These cysts are fairly rare and classified as central (3%), midzonal (21%), peripheral (73%), and dislodged (3%). The majority of iris pigment epithelial cysts are benign and do not require any treatment.

central cysts
Figure 1
The central cysts above were seen in a 62-year-old female with a history of angle closure glaucoma (perhaps due to enlargement of the cysts).
Slit lamp inferior iris posterior mass
Figure 2A
On slit lamp examination , an elevation of the inferior iris is seen. It appears as the iris is being pushed or bowed forward from a posterior mass. Folds in the iris can be seen.
Slit lamp iris is being pushed or bowed forward from a posterior mass
Figure 2B
On slit lamp examination , an elevation of the inferior iris is seen. It appears as the iris is being pushed or bowed forward from a posterior mass. Folds in the iris can be seen.
gonioscopy examination shows a dome shaped mass
Figure 2C
On gonioscopy examination (photo 2-C), the elevated, dome-shaped mass is apparent. With careful inspection, the pigment epithelial cyst can be seen through the pupil on the posterior surface of the iris. Also note the major arterial circle of the iris to the left of the cyst.
Reference:
  1. Lois N, Shields CL, Shields JA, Mercado G. Primary cysts of the iris pigment epithelium. Clinical features and natural course in 234 patients. Ophthalmology. 1998 Oct;105(10):1879-85.

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