Fuchs Heterochromic Iridocyclitis

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  • Chronic, usually unilateral, non-granulomatous, low-grade anterior uveitis
  • Typically occurs in the 3rd to 4th decade of life
  • Equal occurrence in men and women
  • Associated with rubella


  • Corneal endothelial precipitates: small, round, or stellate, gray-white, distributed over the entire corneal endothelium, sometimes associated with feathery fibrin filaments
  • Mild anterior chamber flare
  • Diffuse iris atrophy (earliest finding: loss of iris crypts), small nodules at the pupil margin and stroma
  • Iris heterochromia (80%): usually the affected eye is hypochromic (in blue eyes, the affected eye may be hyperchromic)
  • No posterior synechiae; except after cataract surgery
  • Fine iris/chamber angle neovascularisations (may bleed during cataract surgery), no peripheral anterior synechiae
  • Vitritis
  • Complications: Cataract (typically posterior subcapsular opacity), glaucoma


  • Often no therapy necessary due to low-grade inflammation and poor response to steroids
  • Consider short-term local steroid therapy for moderate to severe inflammation
  • No cycloplegia necessary (as there is no formation of posterior synechiae)


  • EyeWiki Fuchs’ Heterochromic Iridocyclitis
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Nika Bagheri MD, Brynn Wajda MD, et al; Lippincott Williams&Wilkins; 7th Edition (2016)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; Jack J. Kanski MD, Brad Bowling MD; Saunders Ltd.; 8th Edition (2015)