Uncommon Bilateral Involvement in Iridocorneal Endothelial Syndrome: A Case Report

Iridocorneal endothelial (ICE) syndrome is an uncommon ocular condition caused by abnormal behaviour of corneal endothelial cells, resulting in progressive iris atrophy, corectopia, peripheral anterior synechiae, and secondary angle involvement. The disease typically affects one eye, while bilateral presentation is rare and may delay diagnosis. This case report highlights a 41-year-old male presented with gradual, painless blurring of vision in both eyes. On examination revealed inferonasal corectopia, diffuse iris atrophy, extensive peripheral anterior synechiae, adherent leucoma, and an irregular anterior chamber depth. Specular microscopy demonstrated endothelial pleomorphism, loss of hexagonality, and a characteristic dark?light reversal pattern, supporting the diagnosis of ICE syndrome. This case highlights a rare bilateral presentation of ICE syndrome without secondary glaucoma and underscores the importance of endothelial evaluation and long-term follow-up.