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