Ophthalmology · Clinical eye photograph

Kayser-Fleischer Ring

A brownish ring at the edge of the cornea — a Kayser-Fleischer ring from copper deposited in Descemet membrane, the classic eye sign of Wilson disease.

Close-up of an eye with a brown ring along the outer edge of the cornea
Kayser-Fleischer ring at the corneal periphery.Image: Herbert L. Fred, MD, Hendrik A. van Dijk, via Wikimedia Commons — CC BY 3.0.

Written & reviewed by: Kinase Medical Team · Last reviewed: 30 September 2026 · Editorial policy

Key features

  • Golden-brown to dark red-brown ring at the periphery of the cornea, from copper deposited in Descemet membrane (the deepest corneal layer).
  • Early rings may be incomplete and visible only on slit-lamp examination, especially in brown eyes.
  • Frequency depends on presentation: present in >95–99% of patients with neurological/psychiatric Wilson disease, but in only about 30–50% of those diagnosed in the hepatic or presymptomatic stage.
  • Not pathognomonic: also reported in primary biliary cholangitis, chronic cholestasis and cryptogenic cirrhosis.
  • Ring density tracks disease activity; rings shrink and may vanish on chelation therapy (e.g. penicillamine).

Differential diagnosis

Differential diagnosis of Kayser-Fleischer Ring
ConditionHow to tell it apart
Arcus senilisYellow-white lipid ring, common in the elderly; at a young age it can signal hyperlipidaemia.

How it appears in NEET PG

Typically shown as an eye photograph with a young patient who has liver disease or a movement disorder; the question may ask for the corneal layer involved or the underlying metabolic disorder.

Frequently asked questions

In which layer of the cornea is copper deposited in a KF ring?

Descemet membrane — the deepest layer of the cornea — at the corneal periphery.

Is a Kayser-Fleischer ring diagnostic of Wilson disease?

It is strongly suggestive but not pathognomonic; it has also been reported in chronic cholestatic liver diseases such as primary biliary cholangitis.

Do KF rings disappear with treatment?

Yes. With copper-chelating therapy the rings usually shrink and may disappear completely.

Sources

  1. Radiopaedia — Kayser-Fleischer rings
  2. Harrison's Principles of Internal Medicine (textbook)
  3. Adams and Victor's Principles of Neurology (textbook)

Keep practising

For exam preparation and medical education only — not a substitute for clinical judgement, diagnosis or treatment of any patient.