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What is Irido Corneal Endothelial Syndrome (ICE)?

ICE or iridocorneal endothelial syndrome is a rare form of glaucoma which usually is found in only one eye.

ICE is a rare form of glaucoma which usually is found in only one eye.

In this condition, cells on the back surface of the cornea spread over the eye’s drainage tissue and across the surface of the iris. This causes an increase in eye pressure, which can damage the optic nerve. These cells also form adhesions that bind the iris to the cornea, further blocking the drainage channels.

ICE occurs more frequently in light-skinned females. Symptoms can include hazy vision upon awakening and the appearance of halos around lights.

ICE is difficult to treat, and laser therapy is not an effective therapy. ICE is usually treated with medications and/or filtering surgery. The causes of ICE are not fully known.

The three main features of ICE include:

ICE is a group of conditions related to changes in corneal cells and the iris. The syndrome almost always involves cells moving from the cornea to the iris. Loss of cells from the cornea can cause corneal swelling, and the iris andpupil can become distorted. When the corneal cells move, they can block fluid from draining properly through the eye’s microscopic drainage channels. This blockage causes pressure in the eye to build, leading to glaucoma.

Risk Factors and Symptoms

Women get ICE more often than men. The syndrome is usually diagnosed in midlife. Typically, ICE affects only one eye. People with ICE may have pain or blurry vision in one eye or notice changes in the iris or pupil.

How Is ICE Treated?

There is no way to stop the progression of ICE. Treatment is usually focused on managing the glaucoma. Glaucoma treatment involves medication or surgery. This helps reduce pressure in the eye. Your eye doctor might prescribe medication to help reduce corneal swelling. In some cases, a cornea transplant may be necessary.


First posted April 27, 2009; Last reviewed and updated August 19, 2022