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Ophthalmology and Visual Sciences

Siderosis bulbi

Siderosis bulbi

Category(ies): Cornea, External Disease

Entry #1
Contributor: Joanna IM. Silverman, MD; Timothy M. Boyce, MD
Photographer: Jody M. Troyer, CRA
February 13, 2023

These external photographs demonstrate an acquired hyperchromic heterochromia due to a traumatic intraocular iron foreign body in the right eye. Chronic deposition of iron within the iris stroma resulted in the gradual darkening of the native light-colored iris.

Entry #2
Contributor: Justin Risma, MD
Photographer: Ed Heffron

Siderosis bulbi is caused by retention and oxidation of an iron-containing intraocular foreign body. Clinical features include cataract, rust-colored anterior subcapsular deposits, iris heterochromia (affected side is darker), pupillary mydriasis, and depressed electroretinogram (ERG) amplitudes. Other potential sequelae include pigmentary retinopathy, retinal microangiopathy, and open-angle glaucoma. If the cataract and foreign body are removed and there is no macular trauma, the visual prognosis is excellent.

These photos demonstrate iris heterochromia and rust-colored anterior subcapsular deposits in a patient with a history of metal-on-metal ocular trauma. An iris defect and a full-thickness corneal wound are also present inferiorly.

  1. Sneed SR, Weingeist TA. Management of siderosis bulbi due to a retained iron-containing intraocular foreign body. Ophthalmology. 1990 Mar;97(3):375-9. PubMed PMID: 2336277.

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