Iridodialysis is a localized separation or tearing away of the

iris Iris most often refers to: *Iris (anatomy), part of the eye *Iris (mythology), a Greek goddess * ''Iris'' (plant), a genus of flowering plants * Iris (color), an ambiguous color term Iris or IRIS may also refer to: Arts and media Fictional ent ...

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 ciliar ...

.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 In medicine, any disease is classified asymptomatic if a patient tests as carrier for a disease or infection but experiences no symptoms. Whenever a medical condition fails to show noticeable symptoms after a diagnosis it might be considered asy ...

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

polycoria Polycoria is a pathological condition of the eye characterized 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 congenital ...

and experience monocular diplopia,

glare Glare (derived from GLAss REinforced laminate ) is a fiber metal laminate (FML) composed of several very thin layers of metal (usually aluminum) interspersed with layers of S-2 glass-fiber ''pre-preg'', bonded together with a matrix such as epo ...

, 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 of ...

.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 result in damage to the optic nerve (or retina) and cause vision loss. The most common type is open-angle (wide angle, chronic simple) glaucoma, in which the drainage angle for fluid within the eye rem ...

hyphema Hyphema is a condition that occurs when blood enters the front (anterior) chamber of the eye between the iris and the cornea. People usually first notice a loss of vision or decrease in vision. The eye may also appear to have a reddish tinge, o ...

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 Blunt trauma, also known as blunt force trauma or non-penetrating trauma, is physical traumas, and particularly in the elderly who fall. It is contrasted with penetrating trauma which occurs when an object pierces the skin and enters a tissue ...

) 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, o ...

and reduce the perception of double vision.

Causes

Iridodialyses are usually caused by

to the

eye Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conv ...

, but may also be caused by penetrating

eye injuries Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conv ...

."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 2 ...

complication of any

intraocular surgery Eye surgery, also known as ophthalmic or ocular surgery, is surgery performed on the human eye, eye or its Accessory visual structures, adnexa, by an ophthalmologist or sometimes, an optometrist. Eye surgery is synonymous with ophthalmology. The ...

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 of the eye (also called "crystalline lens") that has developed an opacification, which is referred to as a cataract, and its replacement with an intraocu ...

. Iridodialyses have been reported to have occurred from

boxing Boxing (also known as "Western boxing" or "pugilism") is a combat sport in which two people, usually wearing protective gloves and other protective equipment such as hand wraps and mouthguards, throw punches at each other for a predetermined ...

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

deployments, high-pressure water jets, elastic

bungee cord Bungee cords equipped with metal hooks A bungee cord (sometimes spelled bungle; also known as a shock cord) is an elastic cord composed of one or more elastic strands forming a core, usually covered in a woven cotton or polypropylene sheath. The ...

bottle cap A bottle cap or bottle top is a closure for the top opening of a bottle. A cap is sometimes colourfully decorated with the logo of the brand of contents. Plastic caps are used for plastic bottles, while metal with plastic backing is used for gl ...

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 a class of 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 l ...

, and various types of

ball A ball is a round object (usually spherical, but can sometimes be 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 f ...

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, altitude sickness, periodic paralysis, idiopathic intracranial hypertension (raised brain pressure of unclear cause), urine alkalin ...

(a diuretic given to reduce intraoccular 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 fib ...

and ciliary body junction.

References

External links