Corectopia and lipoid proteinosis

The Dynamic Oval Pupil

The dynamic oval pupil is defined and its distinction from corectopia, as well as their different clinical significance is proposed. A literature search for instances presenting this condition yielded only 20 such cases with enough clinical data. A review of these cases allows us to draw some tentative conclusions regarding the most likely anatomical location for its causative lesion and the pathophysiological mechanism responsible for its occurrence.

Urbach-wiethe syndrome and the ophthalmologist: review of the literature and introduction of the first instance of bilateral uveitis

Patients suffering from Urbach-Wiethe syndrome (UWS), also known as lipoid proteinosis or hyalinosis cutis et mucosae, may have an ophthalmologist involved in the diagnosis and management of their disease. Along with moniliform blepharosis as a pathognomonic feature of the disease, an ophthalmologist may encounter other manifestations of UWS in any part of the eye such as cornea; conjunctiva; sclera; trabecular meshwork; iris/pupil; lens and zonular fibers; retina; nasolacrimal duct. This paper provides a review on the pathogenesis and the diverse ocular manifestations seen in UWS patients. Uncommon complications are discussed in this paper (glaucoma; dry eye and epiphora; complications of lens, retina, cornea; iris/pupil and conjunctiva). Moreover, a 27-year-old male UWS patient is described with bilateral diffuse anterior stromal iris atrophy, diffuse keratic precipitates; posterior subcapsular cataract; 1 + vitreous cell in anterior vitreous examination. This case was thought to be the first instance of bilateral uveitis associated with UWS. Overall, ophthalmologists may encounter diverse ocular complications accompanying this syndrome. They should be familiar with well-established ophthalmologic manifestations leading them to cooperate with other specialists in diagnosis and management of the disease.

Congenital corectopia (eccentric pupils): a marker for chromosomal and central nervous system abnormality

We present a case series of five children with congenital corectopia without any associated ocular cause: three had chromosomal abnormalities; one a probable prenatal diplegia, and one bilateral perisylvian dysplasia with vermian and midbrain hypoplasia. Bilateral congenital corectopia is an ophthalmic sign that merits chromosomal analysis and neuro-developmental assessment.

Lipoid proteinosis: Urbach-Wiethe disease

Lipoid proteinosis (Urbach-Wiethe disease) is a rare autosomal recessive disorder in which hyalinized material is deposited in the skin, mucous membranes and brain. Laryngeal changes resulting in hoarseness may be present at birth or in early infancy, often being the first sign of the disease. A typical case is presented.