ICE syndrome- Progressive iris atrophy with secondary glaucoma

Abstract

Iridocorneal endothelial syndrome has three clinical entities- Chandler’s syndrome, progressive iris atrophy and Cogan Reese syndrome. A 40 year old female presented to the department of Ophthalmology with a chief complaint of unusually looking left eye for many years. Ocular examination revealed left eye visual acuity 6/6, Several iris stretch holes at 9 to12 o’clock, with marked iris thinning. Pupil had polycoria and corectopia. Fundus examination revealed normal disc with 0.5cup disk ratio, IOP -24mm Hg. OCT RNLF and visual fields were normal. RE was completely within normal limits. Patient was started on eye drop Timolol 0.5%, 1 drop BD in left eye. On follow up the IOP was under control (18 mm Hg). Since patient had predominant progressive changes in the iris and specific unilateral clinical features, it was diagnosed as essential iris atrophy with early secondary glaucomatous features.