Bilateral acute depigmentation of the iris in a child following exposure to insecticide spray

Abstract

Bilateral acute depigmentation of the iris (BADI) is a rare disease of unkown etiology. We report a case of BADI in a 10-year-old child after accidental exposure to a herbal insecticide. Spontaneous iris repigmentation was observed during the follow-up period.

Bilateral Acute Depigmentation of Iris (BADI) and Bilateral Acute Iris Transillumination (BAIT)-An Update

“…A pattern of slow and gradual recovery with repigmentation and rethickening of the iris stroma has been reported by others as well. 4,9 On the other hand, persistent depigmentation was seen at 4 and 5 years in two other cases reported in the literature. 5,8 There are no fundus changes throughout the disease course and visual acuity is not affected in BADI patients.…”

“…6 Other triggers have been reported as well, including accidental exposure to insecticide spray, fumigation therapy, and pitcher plant extract injections to the face for chronic migraine. 5,9,33 Viral serology for varicella-zoster virus, cytomegalovirus, Epstein-Barr virus, and herpes simplex virus has proven unhelpful 3,4,6,7,12 and polymerase chain reaction analysis of aqueous humor for these pathogens has yielded negative results. 3,10,13,19,34 During the recent COVID-19 pandemic, a total of 19 cases of BADI and BAIT were reported, 18 cases from Turkey and 1 from India.…”

“…Following these early publications, many cases have been reported from other countries. 4,5,6,7,8,9 BADI affects predominantly young females. It presents as a sudden-onset redness, ocular pain, tearing, and photophobia in both eyes simultaneously or within a few days of each other.…”