Ocular complaints are rare. Patients experience symptoms of cirrhosis, neurologic disorders, psychiatric problems, or renal disease. Onset typically between 5 and 40 years of age.
Critical
KayserFleischer ring: 1- to 3-mm, brown, yellow, green, or reddish band that represents copper deposition in the peripheral Descemet membrane (see Figure 13.10.1). Present in 50% to 60% of patients with isolated hepatic involvement and more than 90% of patients with neurologic manifestations. First appears superiorly (may only be visible on gonioscopy) and eventually forms a ring involving the entire corneal periphery extending to the limbus. Anterior-segment optical coherence tomography (OCT) may be useful in detecting early KayserFleischer rings that are not readily detected on slit lamp examination; appears as linear hyperreflective material on Descemet membrane.
Other
Sunflower cataract: Ring or stellate yellow, brown, or reddish anterior capsule opacity due to copper deposition under the lens capsule.
Autosomal recessive inborn error of copper metabolism that results in impaired copper excretion and toxic accumulation of copper in multiple organ systems (e.g., liver, brain, cornea, kidney). ATP7B gene on chromosome 13.