Congenital and acquired coliboma of the iris

The iris of the eye is one of the most important components of the human visual apparatus. It is an automatic diaphragm that divides the space between the lens and the cornea. There are not many ophthalmic diseases that affect the iris. One of the most serious and at the same time rare diseases - coloboma. This is more often a congenital pathology, in which the structural elements of the iris are completely or partially cleaved.

Definition of disease

In medicine, the term "coloboma" was introduced by Walter in 1821.Literally the name of this disease is translated as "mutilation" and is an acquired or congenital defect in the form of absence or splitting of different parts of the visual apparatus, but more often iridescent shell.In most cases, pathology is formed during the period of intrauterine development at 4-5 weeks of pregnancy.The disease is quite rare and occurs only in 1-2% of the entire population.

Most often, coloboma is diagnosed in China, the US and France, so some researchers say about the genetic predisposition to this disease.

Depending on the etiology, they distinguish the congenital and acquired coloboma of the iris, in the second case, it most often develops as a result of eyeball injuries. In addition, there is a one-sided and two-sided pathology, as well as complete (all layers of the shell are affected) and incomplete (the defect is expressed only on the part of the iris).

Causes

The factors that trigger the onset of the disease in the case of congenital and acquired coliboma of the iris differ. There are several reasons for this defect:

• Congenital pathology is an anomaly of fetal development during the formation of the embryonic fissure, that occurs on 4-5 month of pregnancy. As a rule, triggers of this process are cytomegalovirus infection of the mother or genetic mutation;
• Acquired coliboma of the iris can appear due to trauma to the eyeball, at which there is necrotization of its structural elements, or when taking some narcotic or hormonal drugs. In rare cases, the pathology is a consequence of the complication of the operation before the eyes.

There is an opinion that the pathology of the iris can be transmitted autosomal dominant type, that is, only one copy of the defective gene is sufficient for the development of such an anomaly. This process is completely identical to the genetic transmission of hemophilia or color blindness.

Main symptoms

Colonoma of the iris, like most diseases of the eyelids, has pronounced visual signs that are easy to see even without the participation of a specialist.In the case of a defect in the iris, the following symptoms appear:

• There is a cosmetic defect, manifested as a deformed pupil and the iris itself.Outwardly it becomes similar to a pear or keyhole. In some situations, only the pupil changes, and the pigment fringe remains unchanged;
• A specific form of blindness develops, which is commonly called blindness. With it, the ability to distinguish objects remains, but due to pathological changes in the pupil, the ability to regulate the amount of light entering the retina is impaired. This manifests itself in the form of the appearance of flashes of light or, on the contrary, sudden darkening, even in good light;
• Regardless of the etiology of the disease, visual acuity decreases or regular classic or flickering scotoma;
• There is photophobiaand increased tear;
• In some cases, congenital iris lobes are diagnosed with an edge defect. In this case, the pupil itself is enlarged, partially or completely does not react to light. The localization of a defect in the iris can be in any part of it.

Possible complications

The most common complication in coloboma iris is a general decrease in visual acuity or complete loss of vision.Children with a congenital defect often suffer from myopia of varying degrees, astigmatism develops.A prolonged course of the disease can lead to the appearance of a subretinal peripapillary neovascular membrane - an abnormal growth of capillaries in the eye-fund region.

.

What diseases is indicated by hemorrhage in the vitreous (hemophthalmus)

Eye Care: Recommendations for hygiene, prevention of visual abnormalities and eyelid care are described in this article.

How to treat barley on the eye at home with medicines and folk remedies is described here.

.

Treatment

To date, the only possible way to treat the colobals of any department of the iris is surgical intervention.Conservative therapy and all sorts of physiological procedures are ineffective and only temporarily able to eliminate the attendant symptoms. In this case, the operation is not assigned in all cases.Surgical methods are necessary only in the event that there are visual impairments, since there is a risk of complications with the intervention.With a small pathology, it is recommended to wear colored contact lenses or dark glasses, so that the defective pupil does not attract people's attention.

In most cases, the operation with columboma of the iris is a peritomy with subsequent stretching of the edges of the healthy part of the iris and their cross-linking.As a preventive measure, an additional plastic surgery or collagenoplasty is frequently carried out to form an artificial support skeleton.

After the procedure, it is very important to follow all the prescriptions of doctors for the postoperative period. As a rule, prescribe the administration of multivitamin preparations in the form of drops or tablets, as well as lutein complexes.

If an abnormality is detected in a baby, the operation is performed much later, since there is a probability of preservation of visual functions, which can be diagnosed only after the child's six months of life

Prevention

Since coloboma is more often found as an inborn fetal development defect, prevention consists in the proper planning and observance of all medical recommendations during pregnancy.Refusal from hormonal and narcotic means, maintenance of immunity during all trimesters, and also timely diagnosis of child development in the womb are the only possible ways to prevent the development of embryonic pathologies.

Video

conclusions

Coloboma of the pupil is a rare but dangerous ophthalmologic disease.Due to the fact that it has a hereditary and embryonic character, it is difficult to prevent the development of this ailment. However, modern surgical methods allow to eliminate such a defect at any stage of development and practically at any age without a risk to health.

Read also about what is heterochromia and conjunctival chemosis.