The presence of a visible iris sign can be significant in a patient undergoing surgery for involutional aponeurotic ptosis.
The visible iris sign is positive when the iris color can be seen through a closed upper eyelid, which indicates that it is very thin. It occurs in severe involutional aponeurotic ptosis.
A patient with a visible iris sign may have:
(1) retracted levator aponeurosis
(2) thinned tarsus (which is prone to full thickness suture passes)
Consequences may include
(1) tendency to persistent overcorrection after levator advancement
(2) intraoperative difficulties
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