Fuchs Heterochromic Iridocyclitis

Fuchs Heterochromic Iridocyclitis © 2019 American Academy of Ophthalmology

Fuchs Heterochromic Iridocyclitis​




Fuchs Heterochromic Iridocyclitis or sometimes called Fuchs’ heterochromic uveitis (FHU) is a chronic, longstanding mild form of anterior uveitis. It is of unknown cause and most of the time it affects one eye in young adult.

Unlike other uveitis, this disease can be asymptomatic for many years with no redness or eye pain and can be diagnosed accidentally during routine eye examination. Patient can seek medical attention due to its complications which we will discuss later.



What we will see in Slit Lamp Examination

1- Mild anterior chamber activity.

2- Cells deposition on the endothelial layer of the cornea. These cells are called Keratic Precipitates. This deposition is diffuse, white, small and all over the layer.

3- Unlike other form of anterior uveitis, posterior synechia is absence.

4- With Gonioscopy, there will be fine blood vessels that bridge the angle. These are not abnormal neovascularization. These blood vessels can bleed during cataract surgery.



Complications of Fuchs Heterochromic Iridocyclitis


1- Heterochromia

There is diffuse iris atrophy which will cause iris Heterochromia. The affected eye is either hypochomic (lighter) or hyperchromic (darker). Brown and green iris will appear lighter than the normal eye while blue iris will appear darker than the normal eye.

2- Vitreous opacities

Occur in the anterior part of the vitreous and can cause eye floaters which sometimes can be very annoying for the patients can require either steroid medication or Vitrectomy surgery.

3- Cataract

It is a common presentation and can be the main complain of the patient. It causes gradual loss of vision. It can be treated with cataract surgery. These patients have a higher incidence of mild anterior chamber bleeding during surgery.

4- Glaucoma

Glaucoma is a late complication and as we know, this disease is asymptomatic until later stage so it would be very helpful for these patients to have regular follow up



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