Lighter section of iris in 6mth old's eye?

[JJPKOCH]

While feeding our 6 month old daughter yesterday, we noticed a lighter section of colour in her iris at the top right corner of her left eye. It takes up approximately 5% and goes from the white part of her eye (sclera) to the pupil. She has medium to dark blue eyes and this looks to be 30% - 40% lighter than the other sections (a lighter blue). This only shows when you look at it in a specific light, other wise, you would never notice it. We have gone through photos, it only shows up in one photo that was taken over a week ago. (It only shows because of the effect that we selected on the camera, greater contrast in colour). It isn't noticeable unless you pay specific attention to it. What could this be?

[John C Hagan III, MD, FACS, FAAO]

I doubt it is sectoral heterochromia as that is pretty striking, and not difficult to DX.  Just like skin pigment iris from person to person even from eye to eye varies. I would be happy and reassured by the exam and unless something changes likely not worth the time expense of peds ophthal seeing the child. Sounds like a happy ending.  Interesting point. Because each iris is different, no two are alike there is a branch of fortune telling called "iridology" that uses iris like some people us palm reading or tea leaves. Also there is an electronic identification system that use the iris to identify individuals (some also use retina blood vessels) since we're all different.

JCH MD

[JJPKOCH]

Thank you Dr. Hagan.

We went to the ophthalmologist yesterday after work. She did a number of exams and said that everything looks normal; no nerve damage or evidence of strange elements (Tumours or cancer). She said that her eyes were reacting correctly and that aside from the slight (Light) wedge of colour, it all checks out. She said that she would send us for a second opinion if we wanted with a paediatric ophthalmologist, which could take months, but said not to worry. I must say, I googled "iris nevi" and it terrified me. It's the reverse however, her eye is dark blue and has a small lighter wedge. The ophthalmologist said that the iris will change between 3 - 9 months and this could be a result of it. Do you believe this would have additional elements to it? (Can it be sectoral heterochromia?)

[John C Hagan III, MD, FACS, FAAO]

Only an ophthalmologist Eye MD looking at the eye can tell for sure. Suggest you have your pediatrician look and see if referral is indicated. The iris is often multi-colored also spots like freckles (called iris nevi) can cause splotches of different color.

JCH MD