traumatic mydriasis that improves with pilocarpine, prognosis?

[cavalfilter]

i have traumatic mydriasis (iridoplegia) after eye trauma 2 weeks ago.  there is moderate improvement with 1% pilocarpine, but pupil is otherwise fixed, dilated and nonreactive to light.  if the iris contracts with pilocarpine, it must indicate some function of the sphincter.  does anyone know if a positive response to pilo implies a greater chance at recovery?

thanks

[John C Hagan III, MD, FACS, FAAO]

If your trauma was 2 weeks ago you should not be on pilocarpine.   Far too soon to be using that. There is generally inflammation in the eye and pilo makes that worse.   In fact in most cases the eye is dilated with drops to put at rest.

[cavalfilter]

thanks dr hagan.  opthamologist noted resolution of inflammation and tapered my steroids. stopped using pilo for now, nonetheless. i guess time will tell w regard to regaining iris function.  was hopeful because of positive response to pilo.

[John C Hagan III, MD, FACS, FAAO]

Good luck. Know that pilocarpine increases the risk of retinal detachment especially in an eye that has had a history of trauma.