Iris heterochromia

At a Iris heterochromia the rain skins of both eyes are different colors. Mostly the phenomenon goes back to a congenital anomaly, a syndrome or an inflammation and a depigmentation caused in this way. Many heterochromias do not require treatment because they do not affect vision.

What is iris heterochromia?

The eye color is the pigmentation of the iris, i.e. the iris. Normally the eye colors of both eyes are the same. In people with Iris heterochromia is that is not the case. The pigmentation of the skin and eyes is regulated by so-called melanocytes. These are cells that synthesize and express melanin.

Melanin exists in different shades of color: dark brown pigment is called eumelanin, for example, while yellowish-red melanin is called pheomelanin. In a healthy person there is usually a combination of the two pigment types, the exact composition of which determines the individual skin and eye color.

The difference between the two rainbow skins corresponds to a pigmentation disorder, which too Odd-Eye and rarely affects people. White and piebald pets such as cats and dogs are more likely to be affected by the phenomenon. Usually the pigment disorder is depigmentation. In this case, sections of the eye do not contain melanin and thus appear bluish. In addition to congenital forms, iris heterochromia can also be acquired and, in this secondary form, is often the result of iritis.

causes

Iris heterochromia usually corresponds to depigmentation of the iris and can be a congenital phenomenon. In this case, the phenomenon is primarily associated with Waardenburg syndrome, which is based on a mutation-related embryonic differentiation disorder in the neural crests.

In most cases, Waardenburg syndrome is associated with a lack of migration of melanocytes, which leads to pigment disorders. In addition to these pigment disorders of the iris, inner ear hearing loss occurs in the context of the mutation-related syndrome. The acquired form of iris depigmentation is usually causally related to iris inflammation. Such inflammations occur, for example, in the context of autoimmune diseases such as Bechterew's disease, in which the immune system attacks the body's own tissue.

In addition, iritis can correspond to an immunological response to infectious diseases. The rainbow skins can thus, for example, promote inflammation in the case of infections with herpes viruses or Lyme borreliosis and, through the inflammation, promote the destruction of pigment-synthesizing melanocytes, which later becomes noticeable as depigmentation. More rarely, iris heterochromia is the symptom of a sympathetic nerve defect.

Symptoms, ailments & signs

Patients with iris heterochromia have eyes of different colors. The depigmented eye usually looks paler than the other. Congenital pigment disorders of the iris are associated with leucism and, in the context of Waardenburg syndrome, can be associated with further pigment disorders and inner ear hearing loss.

With acquired iris heterochromia due to iris inflammation, the pigment disorder can be accompanied by cataracts and other lens opacities. In many cases, especially with neurogenic causes, there is an unequal pupil size in addition to the inequality of the rainbow skins. The pigment disorder does not normally affect vision.

Sectoral heterochromia is present when it is not the entire eye but only a certain section of the iris that is different in color, so often an iris segment running obliquely to the center. In the case of central heterochromia, there is a differently colored ring at the center of the iris.This form of iris heterochromia occurs frequently in the population and does not have to be associated with diseases.

Diagnosis & course of disease

The diagnosis of iris heterochromia is usually made by visual diagnosis, as the difference in color is immediately apparent. As part of the diagnosis, the cause of the color difference must be determined more precisely. It is mainly about the assessment of the disease value.

In the case of congenital syndromes such as Waardenburg syndrome, a functional test of the hearing is used for diagnosis. Inflammations are traced by means of laboratory diagnostic analyzes. In the case of an inflammation-related cause, the doctor must further differentiate between autoimmunological and infectious triggers in the diagnosis in order to be able to initiate appropriate treatment.

Complications

In most cases, iris heterochromia does not have any particular complications or discomfort. If the iris heterochromia does not lead to impaired vision and in general in everyday life, treatment does not necessarily have to take place. In many cases, the affected person can see better in one eye than the other.

It is not uncommon for iris heterochromia to develop a hearing loss. Especially in young people, hearing loss can lead to depression and other psychological disorders. As a rule, the diagnosis can be made very quickly, as the extent of this disease is directly visible to the doctor. The hearing is also checked, whereby there are no particular complications.

In many cases there is no treatment for this disease. Treatment with antibiotics can only take place in the event of infection or inflammation. This usually leads to success and there are no further complications. If there are visual problems, these can be compensated with the help of glasses. Iris heterochromia does not reduce or affect life expectancy.

When should you go to the doctor?

Normally, a doctor does not need to be consulted with iris heterochromia. It is a change in eye color, but not a health problem. Since vision is not impaired or iris heterochromia does not lead to premature visual impairment, there is no medical need to be concerned. A visit to the doctor is only necessary if the abnormalities are viewed as a visual flaw and this leads to emotional and mental problems.

If there is a depressive experience, feelings such as shame or social withdrawal, a doctor's visit is required. A loss of well-being, reduced performance and apathy are symptoms for which a doctor's visit is recommended. The affected person needs help in the event of behavioral problems or personality disorders that occur due to iris heterochromia. With the help of a doctor or therapist, changes can be made that lead to an improvement in the quality of life.

However, if the eyesight is impaired, vision is blurred or the eyes are quickly tired, a doctor should be consulted. Headache, a feeling of pressure in the eye sockets or inside the head, bleeding in the eye and unusual secretion of secretion from the eye are diseases that must be examined and treated. If the affected person suffers from clouding of the lens, a doctor's visit is also required.

Treatment & Therapy

In most cases, iris heterochromia does not affect vision. For this reason, no further treatment of the phenomenon is necessary in many cases. If the patients feel disturbed by the heterochromia, they are advised to use contact lenses in the required color.

If the heterochromia occurs as part of an acquired disease, treatment of the cause of the trigger is indicated, for example combating infectious inflammation by administering antibiotics. In the case of syndromes such as Waardenburg syndrome, causal therapy is not possible because it is a mutation-related disease. Present symptoms such as inner ear hearing loss are treated symptomatically.

Further therapy for heterochromia is necessary for congenital causes, especially for Fuchs heterochromic cyclitis, since inflammation is also involved in this. In the case of autoimmune inflammation with heterochromia, for example in the context of multiple sclerosis, an acute flare-up is usually reduced with high-dose cortisone.

This anti-inflammatory drug can cross the blood-brain barrier and penetrate the central nervous system. The patients of autoimmune diseases also receive drug relapse prophylaxis to prevent the recurring inflammation.

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Outlook & forecast

Congenital iris heterochromia can be unproblematic in terms of health, but it can also be associated with other congenital disorders. If it is accompanied by Waardenburg syndrome, those affected also suffer from deafness. This disorder is inherited as an autosomal trait, but it can also be traced back to other forms of leucism. However, since all the physical impairments that go with it are innate, there is no possibility of complete healing.

Iris heterochromia as a result of inflammation of the iris, on the other hand, is a consequential damage that indicates that permanent damage has occurred to the iris. In the course of life, this can develop into cataracts or some form of lens opacity, which can ultimately lead to blindness in the person concerned. Until the case actually occurs, her eyesight is not affected by the iris heterochromia and the eyesight remains.

More rarely it happens that the pupil size of the affected eye is influenced and is no longer open or closed to the same extent as the other eye, which can affect the human sense of sight. It is also possible that the affected eye perceives a warmer perspective than the healthy one. If disturbing changes in vision occur, they can be treated in order to restore the normal picture, but the iris heterochromia will remain and can still be recognized as such by outsiders.

prevention

Acquired iris heterochromia due to infections can be prevented to a certain extent by rapid treatment of the causative infectious disease. As far as vaccinations are available, they can also be described as preventive measures. Congenital causes and autoimmune diseases have so far not been successfully prevented.

Aftercare

In the case of iris heterochromia, the follow-up measures are in most cases very limited or are not available to the person concerned. The patient should consult a doctor very early and then initiate treatment so that there are no further complications and no further worsening of the symptoms. An early diagnosis of iris heterochromia always has a very positive effect on the further course of the disease.

For iris heterochromia, treatment is not always necessary, so that in most cases there is also no follow-up care for this disease. The affected person usually has to take antibiotics for iris heterochromia. It is always important to ensure the correct dosage and regular intake of the medication.

The antibiotics should also not be taken together with alcohol, as this would reduce their effect. If anything is unclear or if you have any questions, a doctor should always be consulted first. The disease usually does not reduce the life expectancy of the person affected and can be cured relatively well. Further aftercare measures are no longer necessary.

You can do that yourself

Treatment for iris heterochromia is not always necessary. As a rule, those affected only need treatment if the disease leads to reduced vision or other visual problems. The possibilities for self-help are, however, very limited in iris heterochromia.

The disease itself can be avoided by treating infections and inflammation of the eye quickly and early. The disease can also be counteracted by targeted vaccinations, which are set in consultation with the treating doctor. Those affected are also advised to comply with certain hygiene standards when eye infections occur.

Iris heterochromia is usually treated with the help of antibiotics so that the person does not have to take any further measures. When taking antibiotics, however, attention should be paid to possible interactions with other drugs. If in doubt, you should always consult a doctor to prevent side effects. Drinking alcohol while taking antibiotics is strictly prohibited. The use of specially colored contact lenses can limit the appearance of the disease.