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 | |
Cataract |
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.