1 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Basic clinical distinction ? ? 2 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Basic clinical distinction Primary Secondary 3 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Basic anatomic distinction ? ? 4 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Basic anatomic distinction Epithelial Stromal 5 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Which is more common--epithelial, or stromal cysts? Epithelial, by a mile 6 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Which is more common--epithelial, or stromal cysts? Epithelial, by a mile 7 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Advanced anatomic distinction ? ? 8 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Advanced anatomic distinction Pupillary Iris pigment cysts epithelium cysts 9 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Pupillary cysts --Pigment epi cysts at the…[location] --Presents in…infancy 10 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Pupillary cysts --Pigment epi cysts at the…pupil border --Presents in…infancy 11 Pediatric Iris Cysts and Nodules Primary epithelial pupillary cysts 12 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Pupillary cysts --Pigment epi cysts at the…pupil border --Presents in…[age] 13 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Pupillary cysts --Pigment epi cysts at the…pupil border --Presents in…infancy 14 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…in teensteens --Clinically significant? No[Y/N] 15 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…in teensteens --Clinically significant? No[Y/N] 16 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…[agein…teens range] --Clinically significant? No[Y/N] 17 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…teens --Clinically significant? No[Y/N] 18 Pediatric Iris Cysts and Nodules Primary epithelial pupillary cysts in a teen 19 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Pupillary Iris pigment cysts epithelium cysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…teens --Clinically significant? [Y/N] 20 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal PupillaryPupillary IrisIris pigmentpigment cystscysts epitheliumepithelium cystscysts Iris pigment epithelium Pupillary cysts cysts --Pigment epi cysts at --2o to separation of… the…pupil border epithelial layers --Presents in…infancy --Presents in…teens --Clinically significant? [Y/N]No 21 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 22 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 23 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…[age] infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 24 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 25 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy epithelial --Cysts contain…gobletcell type cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 26 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separation of… --Glaucoma the…pupil border epithelial layers --Induce…corneal decompensation --Presents in…infancy --Presents in…teens --Cyst leakage chronic iritis --Clinically significant? [Y/N]No 27 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o to separationWhy does of… the presence --Glaucomaof goblet cells predispose cysts to enlargement? the…pupil border epithelialRecall layers that goblet cells produce--Induce…corneal mucin . The decompensation production (and sequestration) --Presents in…infancy --Presentsof in… mucinteens that is responsible--Cyst for leakagecyst enlargement. chronic iritis --Clinically significant? No[Y/N] 28 Pediatric Iris Cysts and Nodules Pediatric Iris Cysts Primary Secondary Epithelial Stromal Stromal cysts --Due to stromal sequestration of…epithelial tissue PupillaryPupillary IrisIris pigmentpigment during embryogenesis cystscysts epitheliumepithelium cystscysts --Presents in…infancy --Cysts contain…goblet cells, may cause enlargement Iris pigment epithelium --Result in a number of problems: Pupillary cysts cysts --Obstruct…visual axis --Pigment epi cysts at --2o