A Child With Pigmentation of the Eye

Kevin L. Shen; Kimberly G. Yen, MD


October 10, 2017

Clinical Presentation

A 15-month-old boy presented to the eye clinic because of concerns surrounding an abnormal coloration in his left eye (Figure). The child's parents had noticed this coloration since birth but now observed discoloration of the skin around his eye. They reported that the coloration had not changed significantly over time, and the child appeared to see well. They denied photophobia, tearing, or blepharospasm.

The child was otherwise healthy, and there was no significant medical or surgical history. The family history was negative for ophthalmic conditions.

On examination, the child was able to fix and follow with each eye separately.

The anterior segment exam showed a gray-blue pigmentation of the sclera and a similar pigmentation of the periocular skin. There was no iris heterochromia. The rest of the anterior segment exam was normal.

Intraocular pressure was 15 mm Hg in each eye.

Cycloplegic refraction showed bilateral low hyperopia.

The fundus examination was normal in each eye.

Figure. Abnormal coloration in the left eye of a 15-month-old boy.


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