In iris heterochromia, the rain membranes of both eyes are different colors. In most cases, the phenomenon is due to a congenital anomaly, a syndrome or inflammation and the depigmentation it causes. Many heterochromias do not require treatment because they do not affect vision.
What is iris heterochromia?
Patients with iris heterochromia have different colored eyes. The depigmented eye usually appears paler than the other. See wholevehicles for What are the Meanings of Hereditary Neuropathy with a Tendency to Pressure Paralysis.
The eye color is the pigmentation of the iris, i.e. the iris. Normally, the eye colors of both eyes are the same. This is not the case in people with iris heterochromia. The pigmentation of the skin and eyes is regulated by the so-called melanocytes. These are cells that synthesize and express melanin.
Melanin comes in different shades: dark brown pigment is called eumelanin, for example, while yellowish-red melanin is called phaeomelanin. In a healthy person there is usually a combination of the two pigment types, the exact composition of which isindividualskin and eye color.
The difference between the two irises corresponds to a pigmentation disorder, also known as odd eye, which rarely affects humans. White and piebald pets such as cats and dogs are more likely to be affected by the phenomenon. The pigment disorder is usually a depigmentation. In this case, sections of the eye do not contain any melanin and therefore 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 accompanied by a lack of emigration of melanocytes, which leads to pigment disorders. In addition to these pigment disorders of the iris, sensorineural deafness 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 reaction to infectious diseases. For example, the iris can promote inflammation in the case of infections with herpes viruses or Lyme borreliosis and, as a result of the inflammation, a destruction of pigment-synthesizing melanocytes, which later manifests itself as depigmentation. Rarely, iris heterochromia is the symptom of a sympathetic nerve defect.
Symptoms, Ailments & Signs
Patients with iris heterochromia have different colored eyes. The depigmented eye usually appears paler than the other. Congenital pigment disorders of the iris are associated with leucism and can be associated with other pigment disorders and sensorineural hearing loss in the context of Waardenburg syndrome.
In the case of acquired iris heterochromia caused by inflammation of the iris, the pigment disorder can be accompanied by cataracts and other lens opacities. In many cases, especially in the case of neurogenic causes, there is an unequal pupil width in addition to the unequal iris membranes. Normally, vision is not affected by the pigment disorder.
A sectorial heterochromia is present when not the entire eye but only a certain section of the iris is colour-different, often an iris segment running obliquely towards the middle. Central heterochromia is a ring of a different color in the middle of the iris. This form of iris heterochromia is common in the general population and may not be associated with any disease.
Diagnosis & course of disease
The diagnosis of iris heterochromia is usually made by a doctor’s visual diagnosis, since the difference in color is immediately apparent. The cause of the color difference must be determined in more detail as part of the diagnosis. The main purpose is to assess the value of the disease.
In the case of congenital syndromes such as Waardenburg syndrome, a functional test of the hearing is used for diagnosis. Inflammations are traced using laboratory diagnostic analyses. In the case of an inflammation-related cause, the doctor must further differentiate between autoimmune and infectious triggers in order to be able to initiate appropriate treatment.
Complications
In most cases, iris heterochromia does not cause any particular complications or discomfort. If the iris heterochromia does not lead to impairments in vision and in everyday life in general, then 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 also develop hearing loss. Especially in young people, hearing loss can lead to depression and other psychological upsets. As a rule, the diagnosis can be made very quickly, since the severity of this disease is directly visible to the doctor. Hearing is also checked, with no particular complications.
In many cases there is no treatment for this disease. Treatment with antibiotics can only take place in the case of infections or inflammation. This usually leads to success and there are no further complications. If there are visual problems, these can be corrected with the help of glasses. Life expectancy is not reduced or affected by iris heterochromia.
When should you go to the doctor?
Normally, there is no need to consult a doctor for iris heterochromia. It is a change in eye color, but not a health dysfunction. Since vision is not impaired or iris heterochromia does not lead to premature vision problems, there is no cause for concern from a medical point of view. A doctor’s visit is only necessary if the abnormalities are seen as a visual flaw and this causes emotional and psychological problems.
If you experience depression, feelings of shame or social withdrawal, you need to see a doctor. A loss of well-being, reductions in performance and apathy are symptoms for which a doctor’s visit is advised. In the case of behavioral problems or personality disorders that occur due to iris heterochromia, the person concerned needs help. With the support of a doctor or therapist, changes can be made that lead to an improvement in the quality of life.
If you still experience reduced vision, blurred vision or rapid eye fatigue, you should see a doctor. Headaches, a feeling of pressure in the eye sockets or inside the head, bleeding in the eye and unusual discharge from the eye are diseases that need to be examined and treated. If the person concerned suffers from clouding of the lens, a doctor’s visit is also necessary.
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 patients are bothered by heterochromia, they are advised to use contact lenses of the required color.
If the heterochromia occurs as part of an acquired disease, causal therapy for the trigger is indicated, for example combating infectious inflammation through the administration of antibiotics. In the case of syndromes such as Waardenburg syndrome, causal therapy is not possible because it is a mutation-related disease. Existing symptoms such as sensorineural hearing loss are treated symptomatically.
Further treatment of heterochromia is required for congenital causes, especially in Fuchs heterochromia cyclitis, since inflammation is also involved. In the case of autoimmune-related inflammations with heterochromia, for example in the context of multiple sclerosis, an acute flare-up is usually brought to an end with high-dose cortisone.
This anti-inflammatory drug can cross the blood-brain barrier and thus enter the central nervous system. Patients with autoimmune diseases also receive drug prophylaxis to prevent recurring inflammation.
Outlook & Forecast
Congenital iris heterochromia can be unproblematic in terms of health, but 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 autosomal, but can also be due to other forms of leucism. However, since all the physical impairments that accompany it are congenital, there is no possibility of a complete cure.
On the other hand, iris heterochromia due to inflammation of the iris is a sequela that suggests permanent damage has occurred to the iris. In the course of life, this can develop into cataracts or a form of clouding of the lens, which can ultimately lead to blindness in the person concerned. Until the event actually occurs, her vision is unaffected by iris heterochromia and vision persists.
It happens less frequently that the pupil size of the affected eye is affected and is no longer open or closed to the same extent as in the other eye, which can affect the human sense of vision. 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 to restore normal vision, but iris heterochromia will persist and be recognized as such by outsiders.
Prevention
Acquired iris heterochromia due to infection can be prevented to a certain extent by prompt treatment of the causative infectious disease. As far as vaccinations are available, they can also be described as preventive measures. So far, congenital causes and autoimmune diseases cannot be successfully prevented.
Aftercare
In the case of iris heterochromia, the aftercare measures are in most cases very limited or not available to the person concerned at all. The patient should consult a doctor very early on 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.
Treatment is not always necessary for iris heterochromia, so that in most cases there is no follow-up care for this disease at all. The affected person usually has to take antibiotics for iris heterochromia. It is always important to ensure that the dosage is correct and that the medication is taken regularly.
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, always consult a doctor first. The disease usually does not reduce the life expectancy of the person affected and can be cured relatively easily. Further aftercare measures are no longer necessary.
You can do that yourself
Treatment is not always necessary for iris heterochromia. As a rule, those affected only need to be treated if the disease causes reduced vision or other visual problems. However, the possibilities for self-help are severely limited in the case of iris heterochromia.
The disease itself can be avoided by treating infections and inflammation of the eye quickly and at an early stage. The disease can also be countered by targeted vaccinations, which are given in consultation with the doctor treating you. It is also advisable for those affected to comply with certain hygiene standards in the event of eye infections.
Iris heterochromia is usually treated with the help of antibiotics, so the sufferer does not need to take any further action. When taking antibiotics, however, attention should be paid to possible interactions with other medications. If in doubt, you should always consult a doctor to prevent side effects. It is strictly forbidden to drink alcohol while taking antibiotics. The use of specially colored contact lenses can limit the outward appearance of the disease.