Golden Ring in Eyes: All That Glitters Is Not Gold

Tayde et al report a case of a 20-year-old man who is presented with progressive ascites with pedal edema. On evaluation, he was found to have cirrhosis of the liver with splenomegaly due to portal hypertension. His clinical examination revealed a golden brown ring at the limbus in both eyes. He underwent a slit-lamp examination that confirmed it to be Kayser-Fleischer ring. Identification of the Kayser-Fleischer ring in any patient with unexplained neurologic symptoms, psychiatric disorder, abnormal liver function test results, hepatitis, cirrhosis of liver, or renal tubular acidosis should prompt the physician to perform a workup for Wilson disease. Detecting Kayser-Fleischer ring is one of the screening tests for first-degree relatives of a patient with Wilson disease. Early detection and treatment may prevent the morbidity and mortality of the disease.