HWN Suggests

Iris Injuries

Iris injuries can be caused indirectly by contusion or directly by perforating or penetrating injuries to the eye. Here, globe contusion transmits force to the iris through the rapid displacement of aqueous humor. Because water is incompressible and the eye is inelastic, this force can be rather severe. Penetrating injuries, foreign bodies, stab wounds, corneal lacerations, and ruptured globes can all perforate, tear, or disrupt the iris. More than that, iris tissue often herniates through corneal or scleral wounds. Iridoplegia is caused by damage to the pupillary sphincter. The pupil can react to light directly, consensually, slightly, or not at all. In other cases, patients can present with…

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Articles of Interest

Cut at the Root

Iridodialysis is defined as a rupture of the iris at its thinnest area––the root. Patients with iridodialysis present with a history of jarring, blunt-force trauma, such as being struck with a projectile or participation in a collision injury (e.g., the impact of an air bag or contact with the ground upon falling).

Getting Hosed

Iridodialysis is the separation of the iris root from its ciliary body insertions, commonly sequela of blunt or penetrating ocular trauma. However, intraocular surgical procedures or congenital causes are possible.3 Occurrences are commonly unilaterally and sectoral, although complete dialysis of the iris have been reported. The detachment of the peripheral iris root, the thinnest attachment, results in the classic “D-shaped” pupil sign where the pupillary margin, opposite of the dissection, flattens.

Iridodialysis Repair

The term iridodialysis implies the disinsertion of iris root from the ciliary body that can be traumatic, iatrogenic, or rarely congenital in origin. Numerous techniques have been described in peer literature for the management of this clinical scenario.

Managing the iris after trauma

Traumatic mydriasis. This can result from open or closed globe injuries. Dr Woreta described a case with an iris sphincter tear—a superior iridodialysis, which is defined as separation of the iris from its attachment to the ciliary body—and a traumatic cataract. Diffuse dilation can also occur following trauma.

Options for managing the iris after trauma

When confronted with injuries to the iris, which in many cases can be complex, certain steps help ensure successful outcomes, according to Fasika A. Woreta, MD, MPH, who presented her pearls for managing the iris during open globe repair and reconstruction of the iris following trauma.

The Truth Behind David Bowie’s Eyes

I couldn’t believe my eyes when I was scrolling through my Facebook feed on Monday. First, I was shocked to hear of the passing of David Bowie, but I also noticed that along with this news, there were several stories about his iconic eye appearance. I had always been told, and always believed, that David Bowie’s unusual eye appearance was due to heterochromia iridis… I guess I was wrong! After reading a few of these articles, I found that the real reason David Bowie’s eyes appeared to be different colors was because he had anisocoria! Did you know that? Or had you also been duped into believing he had heterochromia?!

Traumatic Iridodialysis Associated With Hyphema Secondary to Injury From a Bungee Cord

Iris sphincter tears are a common finding in blunt trauma to the anterior eye. Separation between the iris root and ciliary body is referred to as iridodialysis. The sphincter muscles become irreversibly damaged and the subsequent mydriasis causes visual disturbances including glaucoma.

Traumatic iris sphincter tears

Tears in the iris sphincter may occur after blunt eye trauma and result in persistent mydriasis. These photos, taken 4 days after blunt trauma to the eye, show multiple scalloped tears in the iris sphincter along the pupillary margin inferiorly and temporally. Also visible is the traumatic anterior subcapsular cataract.