Acute Unilateral Iris Transillumination Following Topical Moxifloxacin: A Case Report and Anterior Segment Optical Coherence Tomography Findings

PURPOSE: To describe the anterior segment swept-source optical coherence tomography (AS-SS OCT) findings of the iris in a patient with unilateral acute iris transillumination associated with iris depigmentation following topical moxifloxacin treatment for corneal trauma. METHODS: Case report. RESULTS: AS-SS-OCT imaging of the affected iris showed loss of the normal hyperreflective anterior iris border in both the pupillary and ciliary portions. The stromal layer appeared thinned, with patchy clusters of hyperreflective dots throughout the stroma. The homogeneous and poorly defined hyperreflectivity of the iris pigment epithelium was attenuated or completely absent in the most clinically affected areas, allowing light transmission. CONCLUSIONS: AS-SS-OCT imaging demonstrates a distinctive pattern of iris involvement in unilateral acute iris transillumination (UAIT), which, in conjunction with clinical findings, may aid in diagnosis and reveal features overlapping with a BAIT-like phenotype, supporting its role as a valuable diagnostic tool in this entity.