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.
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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