Fuch's Heterochromic Iridocyclitis in Iran: Is the Disease Going to Fade Away?

353 Dear Editor, There is a diverse group of well‐known uveitic entities which are of unknown etiology. Many experts believe that the majority of them are the consequences of unknown infectious pathogens, most probably viral.[1] Fuch’s heterochromic iridocyclitis (FHI) is a well‐known entity, which usually presents as a unilateral low‐grade inflammation in a white eye with diffuse, stellate keratic precipitates and, mild anterior chamber inflammation, iris atrophy and no posterior synechiae.[2,3] In addition there is an associated 70% risk of cataracts and 15% risk of glaucoma.[2,3] FHI is unique in that polymerase chain reaction (PCR) studies on aqueous samples in several clinical studies has identified the rubella virus as the cause of the entity.[4‐6] Nowadays, FHI is rarely seen in uveitis cases in the United States which is in contrast to developing countries. We assume the reason is the difference in national immunization programs between Western countries and developing countries. The mumps, measles, and rubella (MMR) vaccine was licensed in the United States in 1971, although it was first used in 1969. In an epidemiologic study at the University of Chicago, it was shown that after vaccination with MMR vaccine, the incidence of the diseases were decreased by almost 30% each decade afterwards.[7] Today, after over 40 years since starting immunization, a patient with FHI younger than 40 years of age is hardly ever seen which supports the efficacy of vaccination in preventing the disease. MMR vaccination was started routinely as a national health care protocol in Iran since 2005, before which rubella and mumps were not included in the national immunization program. Fuch’s Heterochromic Iridocyclitis in Iran: Is the Disease Going to Fade Away?