Iridocorneal Endothelial Syndrome: A Contemporary Review of Pathogenesis, Multimodal Diagnosis, and Management.

Iridocorneal endothelial (ICE) syndrome is a rare acquired anterior segment disorder characterized by abnormal proliferation and migration of corneal endothelial cells, leading to progressive angle closure, iris abnormalities, secondary glaucoma, and corneal decompensation. Historically divided into Chandler syndrome, progressive iris atrophy, and Cogan-Reese syndrome, ICE is now recognized as a disease spectrum with a shared pathophysiologic basis. Diagnosis and management remain challenging because of variable clinical manifestations and progressive vision-threatening complications. We provide a comprehensive review of ICE syndrome, presenting an updated overview relevant to ophthalmologists on epidemiology, pathogenesis, multimodal diagnosis, differential diagnosis, and current management strategies while highlighting emerging molecular insights and future therapeutic directions.