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Nodules to Neuro!

𝐋𝐢𝐬𝐜𝐡 𝐍𝐨𝐝𝐮𝐥𝐞𝐬⁣⁣ ⁣⁣ Melanocytic hamartoma of iris⁣⁣ ⁣⁣ Associated with ​Neurofibromatosis 1​ (Autosomal dominant with full penetrance) - multiple and bilateral⁣⁣

⁣⁣ 𝘋𝘦𝘴𝘤𝘳𝘪𝘱𝘵𝘪𝘰𝘯⁣⁣ ⁣⁣ ● Well-defined, dome shaped elevations, tan - yellow brown coloured, projecting from the surface of the iris⁣⁣ ⁣⁣ ● Best identified by slit lamp examination⁣⁣ ⁣⁣ ● Visible in children after the age of 6 years⁣⁣ ⁣⁣ ● Size and number increase with age (100% over 21 years of age)⁣⁣ ⁣⁣ ● Important to differentiate them from ​nevi​ which are flat/ minimally elevated, densely pigmented, blurred margins⁣⁣ ⁣⁣ ● Multiple Lisch nodules point to the diagnosis of NF 1⁣⁣ ⁣⁣ 𝘏𝘪𝘴𝘵𝘰𝘭𝘰𝘨𝘺⁣⁣ ⁣⁣ Closely packed dendritic or spindle shaped melanocytes within the anterior layers of iris stroma - normal uveal melanocytes and not nevus cells⁣⁣ ⁣⁣ Diagnostic Criteria of NF 1⁣⁣ ⁣⁣ 1. Six or more cafe-au-lait macules over 5 mm in greatest diameter in prepubertal individuals and over 15 mm in greatest diameter in postpubertal individuals⁣⁣ ⁣⁣ 2. Two or more neurofibromas of any type or one plexiform neurofibroma ⁣⁣ ⁣⁣ 3. Freckling in the axillary or inguinal region⁣⁣ ⁣⁣ 4. Optic glioma⁣⁣ ⁣⁣ 5. ​Two or more Lisch Nodules (iris hamartomas)⁣⁣ ⁣⁣ 6. A distinctive osseous lesion such as sphenoid dysplasia or thinning of long bone cortex, with⁣⁣ or without pseudarthrosis⁣⁣ ⁣⁣ 7. A first-degree relative (parent, sibling, or offspring) with neurofibromatosis type 1 by the above criteria.⁣ Image from Rajan Eye Care Hospital ⁣ #ophthalmology #ophthal #irisnodules #iris #neurofibromatosis #lischnodules

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