Iridodialysis is a localized separation or tearing away of the

iris Iris most often refers to: *Iris (anatomy), part of the eye * Iris (color), an ambiguous color term *Iris (mythology), a Greek goddess * ''Iris'' (plant), a genus of flowering plants * Iris (given name), a feminine given name, and a list of peopl ...

from its attachment to the

ciliary body The ciliary body is a part of the eye that includes the ciliary muscle, which controls the shape of the lens, and the ciliary epithelium, which produces the aqueous humor. The aqueous humor is produced in the non-pigmented portion of the ciliary ...

.Cline D; Hofstetter HW; Griffin JR. ''Dictionary of Visual Science''. 4th ed. Butterworth-Heinemann, Boston 1997. Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainesville, Florida: Triad Publishing Company, 1990.

Symptoms and signs

Those with small iridodialyses may be

asymptomatic Asymptomatic (or clinically silent) is an adjective categorising the medical conditions (i.e., injuries or diseases) that patients carry but without experiencing their symptoms, despite an explicit diagnosis (e.g., a positive medical test). P ...

and require no treatment, but those with larger dialyses may have

corectopia Corectopia is the displacement of the eye's pupil from its normal, central position. It may be associated with high myopia or ectopia lentis, among other conditions. Medical or surgical intervention may be indicated for the treatment of corectopia ...

polycoria Polycoria is a pathological condition of the eye Distinguished by more than one pupillary opening in the iris.Cassin, B. and Solomon, S. ''Dictionary of Eye Terminology''. Gainesville, Florida: Triad Publishing Company, 1990. It may be congenita ...

and experience monocular diplopia,

glare Glare may refer to: * Glare (vision), difficulty seeing in the presence of very bright light * Glaring, a facial expression of squinted eyes and look of contempt * A call collision in telecommunications * GLARE, Glass reinforced aluminium, an ...

, or

photophobia Photophobia is a medical symptom of abnormal intolerance to visual perception of light. As a medical symptom, photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence o ...

.Rappon JM
"Ocular Trauma Management for the Primary Care Provider." Pacific University College of Optometry. Accessed October 12, 2006.

Digital Reference of Ophthalmology. Accessed October 11, 2006. Iridodialyses often accompany angle recession and may cause

glaucoma Glaucoma is a group of eye diseases that can lead to damage of the optic nerve. The optic nerve transmits visual information from the eye to the brain. Glaucoma may cause vision loss if left untreated. It has been called the "silent thief of ...

hyphema Hyphema is the medical condition of bleeding in the anterior chamber of the eye between the iris and the cornea. People usually first notice a loss or decrease in vision. The eye may also appear to have a reddish tinge, or it may appear as a s ...

Hypotony Ocular hypotony, or ocular hypotension, or shortly hypotony, is the medical condition in which intraocular pressure (IOP) of the eye is very low. Description Normal IOP ranges between 10–20 mm Hg. The eye is considered hypotonous if the IOP is � ...

may also occur.

Complications

Those with traumatic iridodialyses (particularly by

blunt trauma A blunt trauma, also known as a blunt force trauma or non-penetrating trauma, is a physical trauma due to a forceful impact without penetration of the body's surface. Blunt trauma stands in contrast with penetrating trauma, which occurs when a ...

) are at high risk for angle recession, which may cause

. This is typically seen about 100 days after the injury, and as such is sometimes called "100-day glaucoma". Medical or surgical treatment to control the IOP may be required if glaucoma is present. Soft, opaque

contact lens Contact lenses, or simply contacts, are thin lenses placed directly on the surface of the eyes. Contact lenses are ocular prosthetic devices used by over 150 million people worldwide, and they can be worn to correct vision or for cosmetic ...

es may be used to improve

cosmesis Cosmesis is the preservation, restoration, or bestowing of bodily beauty.'' Dorland's Medical Dictionary''. 25th ed. Philadelphia: W.B. Saunders Co.; 1995 In the medical context, it usually refers to the surgical correction of a disfiguring defect, ...

and reduce the perception of double vision.

Causes

Iridodialyses are usually caused by

to the

eye An eye is a sensory organ that allows an organism to perceive visual information. It detects light and converts it into electro-chemical impulses in neurons (neurones). It is part of an organism's visual system. In higher organisms, the ey ...

, but may also be caused by penetrating

eye injuries Physical or chemical injuries of the eye can be a serious threat to vision if not treated appropriately and in a timely fashion. The most obvious presentation of ocular (eye) injuries is redness and pain of the affected eyes. This is not, however ...

."Glaucoma: Angle Closure: Traumatic Iridodialysis."
Digital Reference of Ophthalmology. Accessed October 11, 2006. An iridodialysis may be an

iatrogenic Iatrogenesis is the causation of a disease, a harmful complication, or other ill effect by any medical activity, including diagnosis, intervention, error, or negligence." Iatrogenic", ''Merriam-Webster.com'', Merriam-Webster, Inc., accessed 27 ...

complication of any intraocular surgery and at one time they were created intentionally as part of

intracapsular cataract extraction Cataract surgery, also called lens replacement surgery, is the removal of the natural lens (anatomy), lens of the human eye, eye that has developed a cataract, an opaque or cloudy area. The eye's natural lens is usually replaced with an artific ...

. Iridodialyses have been reported to have occurred from

boxing Boxing is a combat sport and martial art. Taking place in a boxing ring, it involves two people – usually wearing protective equipment, such as boxing glove, protective gloves, hand wraps, and mouthguards – throwing Punch (combat), punch ...

airbag An airbag is a vehicle occupant-restraint system using a bag designed to inflate in milliseconds during a collision and then deflate afterwards. It consists of an airbag cushion, a flexible fabric bag, an inflation module, and an impact sensor. ...

deployments, high-pressure water jets, elastic

bungee cord file:Bungee Cord PICT6882a.jpg, Bungee cords equipped with metal hooks A bungee cord (sometimes spelled bungie; also known as a shock cord or an ocky strap) is an elastomer, elastic cord composed of one or more elastic strands forming a core, usua ...

bottle cap A bottle cap or bottle top is a common closure for the top opening of a bottle. A cap is sometimes colorfully decorated with the logo of the brand of contents. Metal caps with plastic backing are used for glass bottles, sometimes wrapped in dec ...

s opened under pressure,

water balloon A water balloon or water bomb is a balloon, often made of latex rubber, filled with water. Water balloons are used in a summer pastime of cooling off through water balloon fights. Water balloons are also popular for celebrations, including celebr ...

fireworks Fireworks are Explosive, low explosive Pyrotechnics, pyrotechnic devices used for aesthetic and entertainment purposes. They are most commonly used in fireworks displays (also called a fireworks show or pyrotechnics), combining a large numbe ...

, and various types of

ball A ball is a round object (usually spherical, but sometimes ovoid) with several uses. It is used in ball games, where the play of the game follows the state of the ball as it is hit, kicked or thrown by players. Balls can also be used for s ...

Treatment

Iridodialysis causing an associated hyphema has to be carefully managed, and recurrent bleeds should be prevented by strict avoidance of all sporting activities. Management typically involves observation and

bed rest Bed rest, also referred to as the rest-cure, is a medical treatment in which a person lies in bed for most of the time to try to cure an illness. Bed rest refers to voluntarily lying in bed as a treatment and not being confined to bed because of ...

. Red blood cells may decrease the outflow of aqueous humor, therefore the eye pressure should be kept low by giving oral

acetazolamide Acetazolamide, sold under the trade name Diamox among others, is a medication used to treat glaucoma, epilepsy, acute mountain sickness, periodic paralysis, idiopathic intracranial hypertension (raised brain pressure of unclear cause), heart f ...

(a diuretic given to reduce intraocular pressure). Accidental trauma during sleep should be prevented by patching with an eye shield during night time. Avoid giving aspirin, heparin/warfarin and observe daily for resolution or progression. A large hyphema may require careful anterior chamber washout. Rebleeds may require additional intervention and therapy. Later, surgical repair may be considered for larger avulsions causing significant double vision, cosmesis or glare symptoms. Surgical repair is usually done by 10-0 prolene suture taking the base of iris avulsion and suturing it to the

scleral spur The scleral spur in the visual system is a protrusion of the sclera (the white of the eye) into the anterior chamber. The spur is an annular structure composed of collagen in the human eye. It is the origin of the longitudinal and circular fibre ...

and ciliary body junction.

References

External links