10 Months after iris sphincter traumatic mydriasis

[Lifeworthliving777]

I experienced a punch causing trauma to iris sphincter about 10 months ago. Traumatic mydriasis. A few small tears at the 7 o'clock on right (dominant) eye. Fractured nose and cheek bone. While the injury has improved, it is still a little bothersome to me. The eye feels a little tired and there is sometimes a burning sensation. A bit of a heaviness at times. When I close my eyes is feels a little swollen or tight. I feel a bit disoriented at times and almost like a migraine sensation. At night it feels a little better, but the eye tends to feel tired by night. In morning it usually feels pretty good and rested, but Im soon aware of the injury and feel like a struggle lies ahead. I did go through a time where I thought less of it, while going through other injury, but lately it has been more troublesome. It is hard to think too much, just have to relax. Pupils have a lot of movement at times I suppose.

Looking for anyone who can relate. Some of the past feedback gives me hope for further improvement over years.  As does the prospect of some kind of prosthetic device implant.

[Lifeworthliving777]

Anyone out there dealing with this? Anyone who tried the iris cerclage surgery?

[JohnHaganMD]

Iris encircling sutures are not generally recommended for small pupils that react.  It is recommended for "blown pupils" that are widely dilated (5 mm or more) and do not react and the person has severe light sensitivity.  When the circular stitch is put in the pupil does not dilate well and the back of the eye can be difficult to see. also the pupil does not react to light or accommodation.

[JohnHaganMD]

It is extremely important that you have been checked out thoroughly by an Eye MD ophthalmologist.  In eyes with blunt trauma there are often less apparent injuries such as retinal tears, retinal detachments, traumatic cataract or dislocation of the lens, traumatic glaucoma,  etc.  As far as the traumatic mydriasis use the search feature has been discussed here many times.

[Lifeworthliving777]

I was checked out by a few VA ophthalmologists closer to the time of the incident. And they just told me about 5 or so microtears in the iris sphincter. In sunlight its nearly the same size, and in darkness it looks pretty big. It has improved a lot, but has been a little troublesome with some tension type headaches/migraines. As the pupils and eyes or really connected to brain, it is normal to feel like when I focus for example or if something excites me to feel some sort of pain or tension in the iris, or is this just in my head? For instance, if I try to read a book and when I look at the book get a headache or feel pain. And when I close my eyes, it definitely feels better than it used to, but still feels kind of swollen or a pressure of some kind. Likewise, contacts lenses on the injured eye do not feel comfortable and are more likely to before dislodged, so Im just wearing glasses, now

[Lifeworthliving777]

I was checked out by a few VA ophthalmologists closer to the time of the incident. And they just told me about 5 or so microtears in the iris sphincter. In sunlight its nearly the same size, and in darkness it looks pretty big. It has improved a lot, but has been a little troublesome with some tension type headaches/migraines. As the pupils and eyes or really connected to brain, it is normal to feel like when I focus for example or if something excites me to feel some sort of pain or tension in the iris, or is this just in my head? For instance, if I try to read a book and when I look at the book get a headache or feel pain. And when I close my eyes, it definitely feels better than it used to, but still feels kind of swollen or a pressure of some kind. Likewise, contacts lenses on the injured eye do not feel comfortable and are more likely to before dislodged, so Im just wearing glasses, now

[JohnHaganMD]

Good, now every year have an Eye MD ophthalmologist check because these problems can develop down the road especially traumatic glaucoma.   Look at this article. you might want to try one of these drops.  The one I've used the most and with success is bromonidine.  LINK   https://www.healio.com/optometry/refractive-surgery/news/print/primary-care-optometry-news/%7B0a11f5f2-4419-4f02-b7fe-89f77af826fd%7D/drops-may-be-practical-for-pupil-management-after-refractive-surgery