Fuch’s heterochromic iridocyclitis

Fuch’s heterochromic iridocyclitis is a chronic form of iritis of unknown cause. It typically affects only one eye (90%). Men and women are equally affected, and the disease tends to come to medical attention between the ages of 20 to 40.  


Decreased vision in one eye due to cataract


The diagnosis is made on examination by an ophthalmologist. There are no special tests.  The features of Fuch’s cyclitis that an ophthalmologist would note are:

Stromal and pigment epithelial atrophy of the iris leading to different coloured irises

Stellate deposits (keratic precipitates) over the entire corneal endothelium

Mild anterior chamber cells which do not respond to steroid drops

Mild vitreous cells

No areas where the iris sticks to the lens (posterior synechiae)

Posterior sub-capsular cataract

Fine blood vessels (Amsler vessels) at the iris / corneal angle

Lesions on the retina are found in 7.5 – 65% of patients


Raised intra-ocular pressure, a risk factor for glaucoma – occurs in 6.3 – 59% of sufferers of Fuch’s depending on study populations



Follow up every four to six months is usual, to check for increased intraocular pressure


Treatment is only necessary if there is raised pressure or if cataracts cause visual loss.

Raised pressure can be treated anti-glaucoma eyedrops of which there are numerous types and brands

In some cases raised pressure needs to be treated surgically, typically with a surgical procedure called trabeculectomy. This procedure is performed at some stage in 25 – 60% of those with pressure increases in Fuch’s, depending on study and surgeon.

Cataracts can be removed surgically if they cause significant visual loss


Equal incidence in men and women

Of patients with iritis, between 1.5 – 10.5% have Fuch’s heterochromic iridocyclitis

You may notice that the percentages quoted vary greatly. This is because different published studies give very different percentages. This probably reflects the absence of an accepted definition of the disease – some ophthalmologists may classify more of their patients as having Fuch’s cyclitis than others.

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