Paediatric Causes of Pupil Irregularity
Single Most Likely Diagnosis
- Congenital anomalies: Such as coloboma, which can cause irregular pupil shape due to abnormal development of the iris. This is a common cause of pupil irregularity in children and is often diagnosed at birth or during early childhood.
Other Likely Diagnoses
- Trauma: Injury to the eye can cause pupil irregularity due to damage to the iris or surrounding structures. This is a common cause of acquired pupil irregularity in children.
- Uveitis: Inflammation of the uvea can cause pupil irregularity due to scarring or adhesions in the iris. This condition can be associated with systemic diseases or infections.
- Congenital cataract: Abnormal lens development can cause pupil irregularity due to associated iris abnormalities.
Do Not Miss Diagnoses
- Retinoblastoma: Although rare, this malignant tumor can cause pupil irregularity due to invasion of the iris or secondary glaucoma. Early detection is crucial for treatment and prognosis.
- Neuroblastoma: This cancer can metastasize to the orbit and cause pupil irregularity due to compression or invasion of the iris or surrounding structures.
- Intraocular foreign body: A retained foreign body in the eye can cause pupil irregularity due to chronic inflammation or scarring.
Rare Diagnoses
- Axenfeld-Rieger syndrome: A rare genetic disorder that can cause pupil irregularity due to abnormal development of the iris and anterior segment.
- Aniridia: A rare congenital condition characterized by partial or complete absence of the iris, which can cause pupil irregularity.
- Ectopia lentis: Abnormal lens position can cause pupil irregularity due to associated iris abnormalities, often seen in conditions such as Marfan syndrome or Ehlers-Danlos syndrome.