Traumatic Iridodialysis

Traumatic Iridodialysis 

  • A traumatic separation between the iris root and ciliary body
  • Is not an uncommon cause of trauma related glaucoma
  • May be caused by nonpenetrating trauma by blunt object or penetrating injury to the globe

Clinical features:

  • Symptoms: pain, blurred vision, history of blunt or penetrating trauma 
  • Signs:
    • Acute phase:
      • Hyphema and an irregular pupil
      • Slightly reduced intraocular pressure due to iritis or increased aqueous
      • outflow through the disrupted structure of the angle
      • Transient elevated intraocular pressure due to hyphema or anteriorly dislocated lens
      • May be associated with lens dislocation
    • Chronic phase:
      • Chronic pressure elevation due to obstruction of the aqueous outflow system from scarring of the torn ciliary body or from peripheral anterior synechiae
      • Optic disc cupping
      • Visual field loss

Management

  • Topical anti-glaucoma agents in the early postinjury period.
  • Surgical repair of iridodialysis if patient symptomatic
  • Filtration surgery (eg, trabeculectomy with antimetabolite therapy) if intraocular pressure uncontrolled medically