Corectopia

Corectopia is a rare ophthalmologic finding in which the pupil is displaced from the center of the iris, resulting in an eccentrically located pupil. It is distinct from dyscoria, which describes an irregularly shaped pupil, and from anisocoria, which refers to a difference in pupil size between the eyes.

Causes and classification: Corectopia can be congenital or acquired. Congenital corectopia may occur with iris dysgenesis conditions such as iris coloboma or other iris anomalies and can be associated with additional ocular abnormalities. Acquired corectopia can arise after ocular trauma, intraocular surgery, or inflammatory diseases that cause iris adhesions or tissue distortion, leading to decentering of the pupil.

Clinical features and diagnosis: Corectopia is identified on slit-lamp examination as a pupil that is displaced from the visual axis. The pupil may be preserved in size or altered in appearance depending on associated iris defects. Diagnosis involves careful assessment to distinguish corectopia from anisocoria (unequal pupil sizes) and from dyscoria (irregularly shaped pupils). Comprehensive ocular examination, including imaging if indicated, helps evaluate accompanying iris or retinal conditions.

Management: Treatment focuses on the underlying cause. Asymptomatic corectopia with otherwise normal vision may require observation. When functional or cosmetic concerns exist, options include surgical pupil reconstruction (pupilloplasty) or the use of prosthetic or artificially centered pupils in select cases. Correcting refractive errors and managing associated ocular conditions are also relevant.

Prognosis: The outcome varies with the underlying etiology and extent of iris involvement. Isolated, stable corectopia may have a favorable prognosis for vision and appearance, whereas associated iris or retinal abnormalities can affect visual function and require ongoing management.

See also: Anisocoria; Dyscoria; Ectopia pupillae; Iris coloboma; Aniridia.