Lisch Nodules
A 40-year-old man with a history of neurofibromatosis type 1 presented to the ophthalmology clinic for a yearly refractive eye examination. He reported no eye symptoms or changes in his vision. An examination of the anterior segment of each eye showed multiple light-brown iris nodules consistent with Lisch nodules. Lisch nodules are melanocytic hamartomas that are common in patients with neurofibromatosis type 1, and their prevalence and number increase with age. Unlike iris nevi, which are flat or minimally elevated with blurred margins, Lisch nodules are elevated above the surface of the iris, have well-defined borders, and occur in multiples. They are part of the diagnostic criteria for neurofibromatosis type 1 and may help to establish the diagnosis in young patients who have few other manifestations of the condition. Because Lisch nodules are not known to result in any ophthalmologic symptoms or complications, no specific treatment was advised. The patient continues to undergo routine annual eye examinations and follow-up with a multidisciplinary neurofibromatosis team. Rodrigo Anguita, M.B., B.S., M.D. Ricardo Veas, M.B., B.S., M.D. Moorfields Eye Hospital, London, United Kingdom