Primary pigment epithelial cysts of the iris

Purpose We want to present a case of bilateral, unusually large pigment epi thelial cysts of the iris. Patient A four-year old girl presented with multiple, unusually large, bila teral pigment epithelial iris cysts and tags at the pupillary margin. The r ight eye additionally presented with two adhesions of the cysts at the corn eal endothelium. Otherwise, the anterior and posterior segment as well as t he intraocular pressure were normal. The visual acuity was at least 0.8 wit hout glasses, and there was no evidence of strabism or other functional imp airments. At normal daylight and with non influenced pupils, the visual axi s was not covered by the cysts. Since the lesions anamnestically appeared t o be congenital and the clinical course had been benign, no therapy was ini tiated. The patient has been checked on at regular intervalls without any f unctional or morphological change. Conclusion Pigment epithelial cysts of the iris usually do not cause any co mplications due to their small size and stationary clinical course. In rare cases, the lesions can be so large, that they get into contact with the co rneal endothelium and sometimes nearly cause visual impairment by covering the visual axis.