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. 1999 Mar;83(3):334–338. doi: 10.1136/bjo.83.3.334

Iris cysts in children: classification, incidence, and management

J Shields, C Shields, N Lois, G Mercado
PMCID: PMC1722970  PMID: 10365043

Abstract

BACKGROUND—Iris cysts in children are uncommon and there is relatively little information on their classification, incidence, and management.
METHODS—The records of all children under age 20 years who were diagnosed with iris cyst were reviewed and the types and incidence of iris cysts of childhood determined. Based on these observations recommendations were made regarding management of iris cysts in children.
RESULTS—Of 57 iris cysts in children, 53 were primary and four were secondary. There were 44 primary cysts of the iris pigment epithelium, 34 of which were of the peripheral or iridociliary type, accounting for 59% of all childhood iris cysts. It was most commonly diagnosed in the teenage years, more common in girls (68%), was not recognised in infancy, remained stationary or regressed, and required no treatment. The five mid-zonal pigment epithelial cysts were diagnosed at a mean age of 14 years, were more common in boys (83%), remained stationary, and required no treatment. The pupillary type of pigment epithelial cyst was generally recognised in infancy and, despite involvement of the pupillary aperture, also required no treatment. There were nine cases of primary iris stromal cysts, accounting for 16% of all childhood iris cysts. This cyst was usually diagnosed in infancy, was generally progressive, and required treatment in eight of the nine cases, usually by aspiration and cryotherapy or surgical resection. Among the secondary iris cysts, two were post-traumatic epithelial ingrowth cysts and two were tumour induced cysts, one arising from an intraocular lacrimal gland choristoma and one adjacent to a peripheral iris naevus.
CONCLUSIONS—Most iris cysts of childhood are primary pigment epithelial cysts and require no treatment. However, the iris stromal cyst, usually recognised in infancy, is generally an aggressive lesion that requires treatment by aspiration or surgical excision.

 Keywords: iris cysts; children

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Figure 1  .

Figure 1  

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Peripheral iris pigment epithelial cyst. Ultrasound biomicroscopy, showing clear cyst (arrow) posterior to the iris (I). The cornea (C) is towards the top of the photograph.

Figure 2  .

Figure 2  

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Mid-zonal iris pigment epithelial cyst. Note that there are two cysts, each of which has an elongated, fusiform shape.

Figure 3  .

Figure 3  

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Pupillary iris pigment epithelial cyst. In this teenager, the lesions were bilateral and were noted shortly after birth. Note that some of the cysts are partly collapsed (iris flocculi).

Figure 4  .

Figure 4  

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Free floating iris pigment epithelial cyst in the anterior chamber in a 12 year old girl.

Figure 5  .

Figure 5  

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Iris stromal cyst located inferonasally in the right eye of an infant.

Figure 6  .

Figure 6  

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Histopathology of iris stromal cyst showing a thick wall and a lumen lined by non-keratinising epithelium similar to conjunctiva (haematoxylin and eosin, original magnification ×25).

Figure 7  .

Figure 7  

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Epithelial downgrowth cyst secondary to perforating corneal trauma in an 11 year old girl. The progressively enlarging lesion was removed by a sector iridectomy.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

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