Heterochromia refers to a difference in iris colour between the two eyes or within one eye. It can be congenital and benign or acquired due to disease or medication.
Types and causes
Colour variation reflects changes in melanin distribution.
- Complete heterochromia one eye a different colour from the other
- Sectoral heterochromia patch of differing colour within one iris
- Associated with conditions like Horner syndrome, Fuchs heterochromic uveitis, or pigment dispersion
- Can be familial and entirely harmless when other findings are absent
Assessment and management
Evaluation focuses on excluding underlying pathology.
- History and examination for anisocoria, inflammation, or pressure changes
- Imaging or systemic work-up if syndromic features are present
- No treatment needed for stable, benign heterochromia
- Cosmetic contact lenses may be used if appearance is a concern
