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Trauma to the Eyelids and Periorbital Region
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
The effects of blunt trauma are likely to result in severe pain, blurred vision and epiphora. These patients have often sustained high velocity injuries to the eye and periorbital region. The cornea is frequently involved and it is thus important to assess for epithelial defects while also ruling out signs of oedema, abrasion and tears within Descemet's membrane. These patients may also present with limbal corneoscleral lacerations. Due to the nature of these injuries patients may additionally present with secondary hyphaema (blood located in the anterior chamber), which is often the result of damage to the structures located in the anterior or posterior chamber. Simply examining the pupil will reveal further evidence regarding the nature of structural damage caused by the injury; in particular it is important to look for signs of iridodialysis and lens stability.
Management of hyphema, repair of iridodialysis, and repair of corneoscleral lacerations
Published in A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha, Vitreoretinal Surgical Techniques, 2019
Because iridodialysis results after trauma or intraocular surgery, concurrent intraocular pathology may exist. Consequently, the clinician must thoroughly examine the eye, looking for other manifestations of blunt or surgical trauma (e.g., angle recession, cyclodialysis, lens damage, zonular rupture, vitreous prolapse, and retinal tear or dialysis).
Ocular history taking and slit-lamp examination
Published in Mary E. Shaw, Agnes Lee, Ophthalmic Nursing, 2018
Look for IridodialysisIris prolapse
Bilateral Acute Iris Transillumination (BAIT): A Rare Syndrome Possibly Associated with COVID-19 and Moxifloxacin Use. A Report of 2 Cases
Published in Seminars in Ophthalmology, 2023
Kristina Lončarić, Rašeljka Tadić, Marin Radmilović, Zoran Vatavuk
On examination in UHC Sestre Milosrdnice her BCVA with Snellen visual acuity charts and decimal notation was 0.5 RE and 1.0 LE. Her pupils were irregularly shaped, semi-mydriatic and nonreactive to light or accommodation. Anterior segment examination with slit-lamp biomicroscopy revealed an iridodialysis from 10 to 12 o’clock in the RE and bilateral iris depigmentation with diffuse iris transillumination defects and pigment deposits on the iris surface (Figure 3). A nuclear cataract OU was noted (LOCS classification N4 on the right, and N2 on the left eye). IOP was measured as 11 mmHg OU with Goldmann applanation tonometry. Gonioscopy examination revealed open iridocorneal angles and heavy pigment deposition in almost all quadrants OU. Dilated fundus examination revealed mild hypertonic vasculature, and paving stone degeneration at 6 o’clock OU. Optic disc examination revealed no glaucomatous damage OU.
Bilateral Subluxation of Microspherophakic Lens in a Child with Cohen Syndrome
Published in Journal of Binocular Vision and Ocular Motility, 2023
Elizabeth A. Chu, Alexandria Cummings, Nicholas Sala, Nicholas Sala
Prior to the lensectomy OS, a brief EUA was performed primarily in the right eye for refraction. Retinoscopy of the aphakic right eye revealed a +18.50D spherical refractive error. Lensectomy OS was performed with a vitrector, and the patient was again left aphakic with follow-up the next day. On post-op day #1 of lensectomy OS, there was resolving hyphema in the anterior chamber that revealed an iridodialysis superotemporally in the left eye from 11 to 5 o’clock from surgical trauma. As management of iridodialysis typically involves observation and bed rest, the decision was made to monitor the patient. She was seen 3 weeks later, at which point all post-op medications were completed. The patient had improved ability to fix and follow compared to the initial presentation. Intraocular pressures were 10 mmHg OD and 9 mmHg OS using iCare tonometer. There was complete resolution of the hyphema and iridodialysis OS. Retinoscopy revealed +18.50D spherical refractive error OU. Of note, calculated average aphakic refraction in a 5-and-a-half-year-old child is +12.84D.1 Spectacles were prescribed as the patient’s full refractive correction. Bifocal addition was considered but withheld due to the patient’s severe developmental delay.
Efficacy and safety of low-concentration, bisulphite-containing, intracameral epinephrine and topical atropine treatments for the prevention of intraoperative floppy iris syndrome
Published in Cutaneous and Ocular Toxicology, 2018
Fehim Esen, Azer Erdagi Bulut, Ebru Toker
The observed complications included temporary increase in intraocular pressure (IOP) at day 1 and posterior capsular rupture (see Table 2). There was no statistically significant difference between the groups for the development of these complications. None of the patients had other previously reported complications including permanent increase in IOP, iris tears, iridodialysis, hyphema, endophthalmitis, retinal detachment or loss of lens fragments3–5. Mean preoperative and postoperative endothelial cell counts (±SD) were 2499 (±211) and 2389 (±327) in Group-NP and 2590 (±233) and 2546 (±344) in Group-EA. The change in ECC was not significantly different between the groups (110 ± 281 in Group-NP vs. 44 ± 138 in Group-EA, p = 0.462).