Trial 3 - Iris Atrophy: the Volk camera failed.

I see a lot of iris shots on Blipfoto, but I've never seen one like this. This is iris atrophy.

This lovely 79 year-old gentleman actually lives in the next street. I asked if I could trial the hand-held camera on him as I'd noticed, whenever we'd exchanged a few words, that he has iris atrophy. He was very obliging. Unfortunately the camera was not! Although there is an anterior eye piece attachment for the Volk camera, it isn't really designed for the task of retro illumination. I tried it a number of different ways but could not get the red reflex. I had my G9 with me though so thought I'd try flash on a macro setting. It bleached everything out, which was unsurprising from such a close range. So I placed some masking tape over the flash (quite a lot of masking tape actually!). It shows up the atrophy quite well I think and at least I now have an ad hoc method of recording iris atrophy when I work in practices without camera attachments on their slit lamps. The fact that the pupil is white is an artefact of the ad hoc equipment rather than any pathology. I had to angle the camera just so to show up the atrophy and the flash must have caught the cornea at that point.

Iris atrophy occurs when the iris degenerates. It's closely linked with glaucoma and this gentleman does indeed have glaucoma, though it's reasonably well controlled now. You can see the red reflex is showing through the iris. You can also see the edge of a lens implant as he's also had a cataract removed and a new intra-ocular lens fitted.

The thick grey ring around his iris is actually on the cornea. It's called Arcus Senilis and is closely linked with high cholesterol and age...he does have high cholesterol and obviously, at 79...some age too!

Off to Whittlesey again tomorrow. No retinal or slit lamp cameras there so the Volk should get a good workout :-)