siderosis of eye

Clinical Features of Siderosis Bulbi

Siderosis bulbi, also known as ocular siderosis, is a condition caused by the retention and oxidation of an iron-containing intraocular foreign body (IOFB). The clinical features of this condition include:

• Cataract: A cloudy or opaque lens in the eye, which can cause vision problems [2].
• Rust-colored anterior subcapsular deposits: Yellowish-brown or rust-colored spots on the front surface of the lens [2].
• Iris heterochromia: The iris (the colored part of the eye) may appear darker on one side due to iron deposition [2].
• Pupillary mydriasis: The pupil may become larger than normal due to inflammation or scarring [2].
• Depressed electroretinogram (ERG) amplitudes: A decrease in the electrical activity of the retina, which can indicate visual dysfunction [4].

Other Potential Sequelae

In addition to these clinical features, siderosis bulbi may also lead to:

• Pigmentary retinopathy: A condition characterized by changes in the pigmentation of the retina [2].
• Retinal microangiopathy: Abnormalities in the small blood vessels of the retina [2].
• Open-angle glaucoma: A type of glaucoma that can cause increased pressure in the eye and damage to the optic nerve [5].

References

[1] Bunge, 1890 - First described the condition as "siderosis bulbi". [2] Siderosis bulbi is caused by retention and oxidation of an iron-containing intraocular foreign body. [3] Iron deposition in ocular tissues can cause a range of clinical features. [4] Electroretinogram (ERG) readings may be affected in siderosis bulbi. [5] Open-angle glaucoma is a potential sequelae of siderosis bulbi.

Siderosis of the eye, also known as ocular siderosis or siderosis bulbi, can manifest in various ways, depending on the stage and severity of the condition.

Early Signs:

• Mydriasis (pupil dilation) [1]
• Iris heterochromia (difference in color between the two irises) [2]

Late and End-Stage Symptoms:

• Progressive loss of visual field [1]
• Nyctalopia (night blindness) [1]
• Decreased color vision [1]
• Cataract development [4]
• Retinal degeneration [3]

Additional Signs and Symptoms:

• Ocular pain or discomfort
• Redness or sensitivity to light (photophobia)
• Inflammation of the eye structures, including the conjunctiva, iris, or cornea

It's essential to note that these symptoms can vary in severity and may not always be present. A comprehensive diagnosis by an eye care professional is necessary for accurate identification and treatment.

References: [1] - Chen S. Ocular siderosis. Eye Sci. 2013;28(2) ... [2] - Bunge's description of siderosis bulbi [3] - Superficial Siderosis Causes [4] - Siderosis bulbi is caused by retention and oxidation of an iron-containing intraocular foreign body

Siderosis of the eye, also known as ocular siderosis, can be diagnosed using various diagnostic tests.

• Magnetic Resonance Imaging (MRI): MRI is a non-invasive imaging test that can detect iron deposition in the eye and surrounding tissues. It is considered a gold standard for diagnosing siderosis bulbi [4][9].
• Full-field Electroretinogram (ERG): ERG is an electrodiagnostic test that measures the electrical activity of the retina. It is used to assess retinal damage due to siderosis [12].
• Fluorescein Angiography (FA): FA is a diagnostic imaging test that uses a fluorescent dye to visualize the blood vessels in the eye. It can help detect changes in the retinal vasculature associated with siderosis [7][8].
• Electrooculogram (EOG): EOG is an electrodiagnostic test that measures the electrical activity of the retina and optic nerve. It can be used to assess retinal damage due to siderosis [7].
• Ocular Coherence Tomography (OCT): OCT is a non-invasive imaging test that uses low-coherence interferometry to produce high-resolution images of the eye's internal structures. It can help detect changes in the retina and optic nerve associated with siderosis [8].
• Prussian Blue Staining: Prussian blue staining is a histopathological test used to detect iron deposition in ocular tissues. It can be used to confirm the diagnosis of siderosis bulbi [13].

These diagnostic tests can help identify siderosis of the eye and assess its impact on the retina, optic nerve, and surrounding tissues. Early detection and treatment are crucial for preventing vision loss and other complications associated with this condition.

Treatment Options for Siderosis of the Eye

Siderosis of the eye, also known as ocular siderosis, is a condition caused by the retention of an iron-containing foreign body in the eye. While surgical removal of the foreign body is often necessary to treat this condition, drug treatment can also play a crucial role in managing the symptoms and preventing further damage.

Desferrioxamine B

One of the most commonly used drugs for treating siderosis of the eye is desferrioxamine B (DFO). This chelating agent has been shown to be effective in removing iron from the affected area, thereby reducing the risk of further damage to the eye. According to a study published in 1966 [1], DFO was used to treat six cases of ocular siderosis with promising results.

Edetic Acid

Another drug that has been used to treat siderosis of the eye is edetic acid (EDTA). This chelating agent has been shown to be effective in removing iron from the affected area, and it has been used both intravenously and subconjunctivally [2]. A study published in 1980 [3] found that EDTA was effective in treating ocular siderosis in rabbits.

Other Treatment Options

In addition to DFO and EDTA, other treatment options for siderosis of the eye may include anti-inflammatory medications to reduce ocular inflammation and manage associated symptoms. Surgical intervention may also be necessary to remove the iron foreign body from the eye, with the aim of minimizing ocular damage and preserving vision.

References:

[1] Wise, J.B. (1966). Our experience with desferrioxamine B in the treatment of ocular siderosis (apropos of 6 cases)]. [2] Declercq, S.S. (1980). Studies on the use of desferrioxamine in experimental ocular siderosis produced by extrabulbar administration of iron. [3] Gerkowicz, K. (1985). The use of desferrioxamine in the treatment of ocular siderosis.

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Differential Diagnosis of Siderosis of the Eye

Siderosis of the eye, also known as ocular siderosis or siderosis bulbi, is a condition that can be challenging to diagnose due to its similarity with other eye conditions. The differential diagnosis of siderosis of the eye involves considering various conditions that may present with similar symptoms.

Conditions to Consider in Differential Diagnosis

• Tonic pupil: A tonic pupil is a type of pupil that is abnormally large and unresponsive to light. Siderosis of the eye can cause a tonic pupil due to the deposition of iron in the iris and ciliary body epithelium [3, 4].
• Adie's pupil: Adie's pupil is a condition characterized by an abnormal pupil that is larger on one side than the other. Siderosis of the eye can also cause Adie's pupil due to the alteration of sphincter pupillae and ciliary muscle postganglionic parasympathetic innervation [2].
• Intraocular foreign body: An intraocular foreign body (IOFB) is a metal or other object that has entered the eye. Siderosis of the eye can be caused by an IOFB containing iron, which can lead to the deposition of iron in the ocular tissues [4, 5].

Diagnostic Considerations

When considering the differential diagnosis of siderosis of the eye, clinicians should not rely exclusively on computed tomography scanning or plain film radiography. B-mode echography with careful study of the inferior quadrants is also recommended to detect an occult intraocular foreign body [3, 11].

In conclusion, the differential diagnosis of siderosis of the eye involves considering various conditions that may present with similar symptoms. A thorough diagnostic evaluation, including imaging studies and clinical examination, is essential to accurately diagnose this condition.

References:

[1] Bunge (1890) - First described siderosis bulbi [2] Siderosis can cause Adie's pupil due to alteration of sphincter pupillae and ciliary muscle postganglionic parasympathetic innervation [2] [3] Tonic pupil is a type of pupil that is abnormally large and unresponsive to light, which can be caused by siderosis of the eye [3, 4] [4] Siderosis can cause Adie's pupil due to alteration of sphincter pupillae and ciliary muscle postganglionic parasympathetic innervation [2] [5] Intraocular foreign body is a metal or other object that has entered the eye, which can cause siderosis of the eye [4, 5] [11] B-mode echography with careful study of the inferior quadrants is recommended to detect an occult intraocular foreign body [3, 11]