Noticed Redness With Gray Spot On Iris Of A Baby. Not Cured By Medicine. Underlying Cause?

Posted on Thu, 21 Mar 2013

Question: my boy just turned 10. 2 months ago I noticed a small gray spot over the corner of his left iris at 4 o'clock . An OD prescribed some drops since the eye was reddish and the doc suspected allergies. The gray spot is still there. Redness is gone. No pain. Normal vision. Now the OD suspects a foreign body, perhaps a grass fiber embedded in the gray spot. I used magnifying goggles and I only see a gray patch 1 to 2 mm in diameter.

Answered by Dr. Naseem (1 hour later)

Hi there,

Thanks for posting your question here.

The picture you have sent is clear enough to visualise a nebular opacity at the site. This refers to the haze seen by you at 4 o'clock.

However, to properly determine presence or absence of a foreign body, you require what is called a slit lamp picture which is what you see through the equiment of an ophthalmologist.

Does your son give complaint of a foreign body in the eye?
Did the process begin suddenly which is the case with foreign bodies.
What medication was he using? If there was a mild steroid in the eye drops, it can reduce the inflammation significantly.

If you could revert back with a detailed history and symptoms during the onset, I could better decide on the cause of the lesion. If it is a grass particle in the eye, it has to be removed in stages depending on how XXXXXXX it has penetrated.

Awaiting your response...

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Naseem (23 hours later)

thank for your answer doctor Naseem,
Apparently, symptoms started as any pink eye symptoms.
How can a plant fiber get into a stroma epithelium without any injury episode that would have left other signs such as scratches around his eye?
Could you please explain why it needs to be removed in stages, and the type of anesthesia?
yes, the drops contained steroids, and the redness disappeared.
yes, the optometrist used a slit lamp to visualize what he describes as a XXXXXXX plant fiber in the stroma epithelium.

Answered by Dr. Naseem (1 hour later)

Steroid drops curb almost all cases where there is inflammation secondary to a foreign body. The only thing they aggravate is the infective component if present. Surprisingly, there was not much of that in your son's eye or it would have worsened with the drops.

The plant fibre or any foreign object initially is imbedded on the epithelium of the cornea and at that stage is easily visible superficially and does not have to have any other injury marks. It could have easily entered from the environment on a windy day.

If left in, it gradually sinks into the corneal stroma as the epithelium grows over it when the pain and discomfort subsides.

Particles like plant matter can cause an antigenic reaction and infection so are best removed. When I say stages, it means the ophthalmologist initially scrapes the surface with a needle to remove epithelium. Hopefully, the particle is right there and can be removed with a forceps followed by eye patching. Sometimes, it may be too XXXXXXX in which case a little is left and tried again at a later date. This is evaluated based on how XXXXXXX it is to begin with. Digging is done if it is not more than 25% through the cornea.

Again, it is seen with a slit lamp to judge. If it looks risky, digging is not recommended and the benefits of surgical removal vs. leaving it alone are considered.
Any sign of a flare up and it has to be removed surgically after which everything dramatically subsides.
You need to have the eye seen by an ophthalmologist to know how XXXXXXX and how reactive the particle is.
Hope this helps. Do revert with anything more I can help you with.
Regards.

Above answer was peer-reviewed by : Dr. Vaishalee Punj