Golden brown pigmented rings in the eyes
BMJ 2024; 385 doi: https://doi.org/10.1136/bmj-2023-077962 (Published 11 April 2024) Cite this as: BMJ 2024;385:e077962
- Bangtao Yao, associate professor1,
- Jun Yang, neurologist2,
- Yong Zhang, radiologist3
- 1Department of Ophthalmology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui branch, Southeast University, Nanjing, Jiangsu Province, China
- 2Department of Neurology, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui branch, Southeast University, Nanjing, Jiangsu Province, China
- 3Department of Medical Imaging, Nanjing Lishui People’s Hospital, Zhongda Hospital Lishui branch, Southeast University, Nanjing, Jiangsu Province, China
- Correspondence to: B Yao yaobamtao_njmu{at}163.com
A woman in her late 30s presented with golden brown lesions of both corneas during a routine ophthalmic examination. She had no ocular discomfort, systemic problems, history of alcohol consumption, or personal or family history of eye diseases. Her best corrected visual acuity was 20/20 in both eyes. On slit lamp examination, golden brown rings were visible at the edges of each cornea (fig 1). Anterior segment optical coherence tomography showed hyper-reflective bands on the periphery of each cornea at the level of Descemet’s membrane, indicating a Kayser-Fleischer ring. No other ocular abnormalities were detected.
Slit lamp examination showing golden brown rings (arrows) at the edge of each cornea (R=right eye; L=left eye)
Questions
1 What is the most likely diagnosis?
2 How would you manage this condition?
3 What is the prognosis?
A
1 What is the most likely diagnosis?
Wilson’s disease—an autosomal recessive genetic disorder caused by mutations in the …
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