EyeRounds Online Atlas of Ophthalmology

Contributor: William Charles Caccamise, Sr, MD, Retired Clinical Assistant Professor of Ophthalmology, University of Rochester School of Medicine and Dentistry

Category: Pediatrics

Esotropia OS with bilateral coloboma of the iris

The colobomata cannot be seen because of the heavy brown pigmentation of this Hindu-Indian's irides. The lower lids prevent a view of the inferior portion of the cornea of each eye. The pyriform shape if visible to the observer would immediately suggest the presence of a coloboma of the iris of each eye. Binocular indirect ophthalmoscopy is essential in order to determine the degree of involvement of the fundus. It is interesting how often the pyriform shape of the cornea with coloboma of the iris is missed in textbooks.In Velhagen: Der Augenarzt, pages 27-35, Vol. IV,1961, there are 4 artist's depictions of coloboma of the iris. In all 4 drawings, the cornea is a perfect circle. However, an actual photograph Abbildung 5, p.31, of a typical coloboma of the iris shows a pyriform cornea in the left eye.

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