title: Iridoschisis and keratoconus in a patient with severe allergic eye disease and compulsive eye rubbing: a case report.
abstract: BACKGROUND
  Iridoschisis is a rare disorder characterized by splitting of the anterior and posterior iris stroma, resulting in disintegrated iris fibrils which float freely in the anterior chamber. We report an exceptional case of bilateral iridoschisis occurring in conjunction with keratoconus and severe allergic eye disease.
  
  
  METHODS
  A 24-year-old white man had had periocular contact dermatitis and allergic eye disease from the age of 3 years. He was allergic to grass, animal hair, and pollen and worked grooming horses. He compulsively rubbed his eyes. There was no history of previous blunt trauma to either eye. There were signs of bilateral iridoschisis and keratoconus with allergic conjunctivitis, all of which were more severe in his right eye. An open drainage angle was identified bilaterally on gonioscopy, excluding primary angle closure. There was no evidence of glaucoma in either eye.
  
  
  CONCLUSIONS
  There are two previous cases reporting the combination of iridoschisis and keratoconus, but no clear common etiology has been identified. In this case there was no evidence of angle closure but there were signs of allergic conjunctivitis. This amalgamation of signs might be explained on the basis of habitual eye rubbing. Treating the allergic eye disease has attenuated this behavior.
authors.affiliation: The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, , Headington, Oxford, OX3 9DU, UK.
authors.forename: Imran H
authors.initials: IH
authors.lastname: Yusuf
authors.affiliation: The Oxford Eye Hospital, West Wing, John Radcliffe Hospital, Headley Way, , Headington, Oxford, OX3 9DU, UK. john.salmon@ouh.nhs.uk.
authors.forename: John F
authors.initials: JF
authors.lastname: Salmon
mesh_terms: D003192:Compulsive Behavior; D003233:Conjunctivitis, Allergic / Q000150:complications*; D003876:Dermatitis, Atopic / Q000150:complications*; D019557:Dermatitis, Perioral / Q000150:complications*; D006801:Humans; D007499:Iris Diseases / Q000209:etiology*; D007640:Keratoconus / Q000209:etiology*; D008297:Male; D012720:Severity of Illness Index; D055815:Young Adult
keywords: Allergic eye disease; Eye rubbing; Iridoschisis; Keratoconus; Open drainage angle