Occasionally the left and right irides may show a difference in color (heterochromia). In hyperchromic heterochromia the abnormal iris has a darker color than the normal (opposite) iris.
Differential diagnosis of hyperchromic heterochromia:
(1) prolonged anterior or posterior chamber hemorrhage
(2) coloboma
(3) congenital (hereditary or sporadic)
(4) Waardenburg-Klein syndrome
(5) Bloch-Sulzberger syndrome
(6) iris abscess
(7) iris stromal cyst
(8) malignant melanoma of the iris
(9) monocular melanosis
(10) nevus
(11) microcornea
(12) neovascularity
(13) neurofibromatosis
(14) siderosis from intra-ocular iorn foreign body
(15) contusion or perforating injury when patient is less than 7 years old
(16) contusion with hypertrophy of the superficial layers of the iris stroma
(17) Bremer syndrome (status dysraphicus)
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