Unusual Case of Coloboma of the Iris with Dextrocardia and Criss Cross Heart Presented Later with Left Sided Diaphragmatic Hernia: First Case Report

Coloboma of the iris (CI) is an embryonic condition resulted from an incomplete formation of the iris which either presented unilateral or bilateral and as a single eye defect or in association of other eye anomalies. It happens either as an isolated condition or as part of syndromic features or other associations that are well reported in literatures. Coloboma of the iris has been reported in association with diaphragmatic hernia and in some syndromes with dextrocardia. It can happen in families with genetic presentation looks like autosomal dominant pattern, however other genetic pattern were also reported. The combination of CI, dextrocardia, Criss Cross Heart (CCH) which is a rare condition by itself and the congenital diaphragmatic hernia (CDH) has not been reported before. This report is about an unusual case of a boy presented after birth with left sided CI associated with dextrocardia and CCH, who presented later at the age of 16 months with left sided congenital diaphragmatic hernia that was not been diagnosed early. As far as this search for the English literatures concerned, this is the first report of this exclusive association. It is therefore, highly recommended to investigate cases of CI for an associated CDH especially if it is associated with congenital heart defects such as dextrocardia and CCH