Wilson’s Disease: Ophthalmic Manifestations

Classic ophthalmic manifestations: “Kayser-Fleischer ring” (copper around cornea) and “Sunflower cataract” (copper in the lens)
rarely affects vision unless cataract is very advanced
Unless the disease is very advanced and/or has been present for years, it is impossible for one to detect subtle copper deposition in the cornea, iridocorneal angle, or lens without an office-based slit lamp exam and gonioscopy (only available in the outpatient setting)
The presence or absence of a Kayser-Fleischer ring does not rule in or rule out the disease
Testing for decreased ceruloplasmin, urinary copper levels, and genetic testing are more effective diagnostic methods
If concerned about the visual impact of a developing sunflower cataract, an outpatient ophthalmology referral is appropriate