Bilateral acute iris transillumination

Abstract

SummaryAtrophy and/or depigmentation of the iris is seen in a number of inflammatory and noninflammatory conditions, including viral iridocyclitis, Fuchs uveitis syndrome, Vogt–Koyanagi–Harada disease, pigment dispersion syndrome, acute angle closure glaucoma, and trauma. An acute onset of severe photophobia associated with bilateral acute iris transillumination with variable sphincter paralysis and pigment dispersion has been recently reported as an adverse effect of oral moxifloxacin. In our experience, only 23% of patients presenting with these findings report moxifloxacin use while more than 60% report a preceding viral illness. Pigment dispersion may persist for several months, refractory glaucoma may develop, and diffuse iris transillumination and syphincter paralysis are irreversible in this entity.