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Despite its continued presence within complementary and alternative medicine, iridology has not been incorporated into mainstream medical practice. This review critically examines iridology from an ophthalmologic perspective, addressing its historical origins and epistemological foundations, proposed mechanisms, biological plausibility, and clinical evidence. A systematic appraisal of the available literature, including the most recent government-commissioned evidence evaluation, demonstrates a consistent lack of diagnostic accuracy, reproducibility, and pathophysiological rationale. The ethical and clinical implications of iridology use are discussed, with particular attention to the risk of delayed diagnosis and patient misinformation. Based on the totality of evidence, iridology cannot be supported as a diagnostic or screening tool in ophthalmology or general medicine.<\/jats:p>","DOI":"10.1007\/s00417-026-07342-w","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T08:32:55Z","timestamp":1782376375000},"page":"3027-3035","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Iridology: Biological plausibility, clinical evidence, and implications for ophthalmic practice"],"prefix":"10.1007","volume":"264","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6664-1327","authenticated-orcid":false,"given":"Lorenzo","family":"Iuliano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-5348","authenticated-orcid":false,"given":"Daniele","family":"Veritti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3746-141X","authenticated-orcid":false,"given":"Paolo","family":"Lanzetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,25]]},"reference":[{"key":"7342_CR1","unstructured":"Yanoff M, Sassani JW (2014) Ocular Pathology: Seventh Edition. 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This article is a narrative mini-review based entirely on previously published literature and does not involve human participants, animal subjects, or identifiable personal data.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors concur with the submission and agree for publication.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}