Year: 1972
Type: article
Study design: Observational Study
Abstract: Cutaneous pigmentation is a well-recognized feature of idiopathic haemochromatosis and, in various series, has been recorded in up to 8o per cent. of patients (Finch and Finch, I955).In the world literature there are occasional reports of pigmentation in the gums (Saundby, I890), buccal mucous membranes (Richardiere, I895), lips (Parker, I903), and tongue (Hess and Zurhelle, I905), and Maddox (I933) recorded the presence of dis- colouration around the disc margin of the retina in four patients with haemochromatosis.The past finding was also observed by Hudson (1953) in one of the five patients he examined.Apart from these reports, however, abnormal pigmentation in the eye has received little attention.In this paper we describe findings related to the occurrence and distribution of melanin and iron in the extraocular structures and within the eye, in haemochromatosis, based on a study of 44 patients. PatientsOf the 44 patients examined, 42 had primary idiopathic haemochromatosis, defined according to the criteria of Williams (I968), and the other two had alcoholic cirrhosis with secondary iron over- load.All 44 patients were of the Caucasian race. MethodsPigmentation of the conjunctiva and lid margins was looked for using direct slit-lamp examination, and a careful search was made for pigmentation in the cornea, uvea, lens, and retina.Ocular photographs were taken with a coupled Zeiss-Ikon camera using high-speed Ektachrome film. Results CONJUNCTIVAL PIGMENTATIONBrown pigmentation of the conjunctiva was detected in eight patients.The pigment was present in the bulbar conjunctiva and was confined to the area adjacent to the limbus, encroaching on to the cornea.It was most marked along the inferior border of the limbus extending to the medial aspect of the globe opposite the interpalpebral fissure.Some pigmentation was also detected along the superior border of the limbus.The deposits of pigment in the conjunctiva tended to be given a radial striation by the inter- vening lymphatic channels, while in one patient horizontal striae were seen which were probably due to the mechanical effects of rucking of the conjunctiva with movements of the lower lid (Fig. I, opposite).
Source: British Journal of Ophthalmology
DOI: 10.1136/bjo.56.4.338
Authors: G Davies, I Dymock, J Harry, R Williams
Institutions: University of London, King's College Hospital
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2001449638